Thursday, October 31, 2019

ADA Makes Their Position Known on Dental Care for Seniors


As our medical and healthcare system gets better and better, life expectancy AND quality of life continues to extend and improve.  However, with folks living longer, there is also the resultant problem of continuing with being able to function as we are accustomed to.

The problem for many is that they are now surviving longer than healthcare benefits were designed to last.  Actuarial tables are best guess estimates, but they are guesses none the less.  Because of that and the fact that many folks are going to need dental care throughout their extended lifespan, the American Dental Association made the current announcement today.  I feel it bears repeating here.  We *need* to take care of those who came before us.  We need to help those who are less fortunate and in need of our help.  I’m proud of the ADA for making their position known.

The American Dental Association has long recognized the importance of oral health care as a crucial part of overall health. For our senior population, those 65 and older, this statement is particularly relevant. Today's ADA strives to build upon previous leaders' efforts to educate and elevate this issue’s importance. Within the elderly cohort, who continues to expand numerically, it is imperative that the American Dental Association become the solution-based resource for this critical and time-sensitive issue.
The current discussions in Washington, DC, may have caught your attention. There are numerous House Bills attempting to add healthcare services to Medicare Parts A and B, and many include a dental benefit. The American Dental Association sees the pros and cons of individual aspects within these legislative bills, and we strive to yield positive results for both our members and the public.
Allow me to introduce the ADA Elder Care Workgroup.
The Current Landscape of Access to Dental Care for Seniors
Prior to introducing ADA efforts pertaining to elder oral care, it is useful to review the current landscape of dental care access for the elderly cohort. The ADA Health Policy Institute maintains the most robust data on the U.S. dental care system, drawing on publicly available as well as proprietary data sources.In 2018, the number of US citizens age 65 and over was 57 million, and that figure is anticipated to balloon to 84 million by 2050.

37% of seniors have some source of dental benefits coverage. Approximately 26% have private dental coverage, and 11% have public dental coverage (for example, Medicaid, Tricare, or the small number who receive dental benefits through Veterans Affairs).

63% of seniors do not have any form of dental benefits coverage.

What does coverage translate to in terms of oral health care use?43% of seniors had a general dental visit in 2016, up from 38% in 2000.

69% of seniors with private dental coverage had a dental visit in the past year.

16% of seniors with public dental coverage visited the dentist.

37% of seniors who are uninsured had a dental visit last year.

Dental care use also varies by household income.61% of seniors with household income above 400% of the federal poverty level visited the dentist.

24% of seniors with household income below 100% of the federal poverty level visited the dentist.

The disparities in dental care use and dental benefit coverage have clear implications for oral health. When it comes to various measures of seniors’ oral health, such as prevalence of untreated cavities or tooth loss, disparities by income, race, and dental insurance status are widening over time. That is, high-income seniors, in general, are seeing improvements in their oral health while for low-income seniors, improvements are either not as large or, in some cases, are non-existent.
The Time to Act is Now
As your president, I felt it was important that the ADA, as America's leading advocate for oral health, share this data with policymakerson the House Ways and Means Committee as they consider policy options to improve access to dental care among seniors, specifically through Medicare reform. Sharing data with policymakers in no way signals that the ADA supports any particular bill.

Data in and of itself is also not ADA policy. As a science-based organization, data is an extremely important input, but it is ultimately up to our esteemed House of Delegates to consider and vote upon resolutions to create ADA policy.

Looking back, the oral health success of Medicaid and CHIP for our youth has benefitted millions of young Americans. However, our elderly's oral health has not received the same discerning attention as our nation's children. This has been a widely discussed topic over the years within the ADA, and this topic's interest has escalated within the ADA House of Delegates over the past three years. In October, 2018, your ADA House of Delegates authorized Past President Dr. Jeffrey Cole to form the Elder Care Workgroup (ECW). Dr. Cole selected eleven dentists and one physician from varied backgrounds, and I reappointed the Elder Care Workgroup in September, 2019.

The Elder Care Workgroup felt strongly that in order for any dental program to be effective in improving the oral health of seniors and providing for their care, a robust network of providers is essential. If dentists are to be incentivized to enroll and provide care under a program, reimbursement must be at a level that accounts for the unique cost of dental care delivery.

After numerous meetings involving spirited, academic, informed and respectful debate, and secluded in their deliberations, The Elder Care Workgroup will present to the 2020 ADA House of Delegates a list of options. These options include a select portion of Center for Medicare and Medicaid Services (CMS) programs suitable for dentistry’s delivery model.

Thus, the Elder Care Workgroup has developed a multi-faceted approach, recognizing that the elder oral care issue's enormity requires innovative thinking. The ECW pursued solutions resulting in coverage for every elderly socio-economic level. The ECW's recommendations are not yet policy as the ADA House of Delegates has yet to vote. However, the ECW's work is progressing towards a presentable House of Delegates product next October.

I am proud to say that your ADA is on the leading edge of a solution, one involving private, non-profit and government programs.

The question is not, "should we do something." The question is, "how do we do it." The time to act is now.

Wednesday, October 30, 2019

Objective By the Sea Conference is Coming this Spring on Maui


If you are into security and especially security that revolves around all things Apple, it’s time to start preparing for Objective by the Sea Version 3.0

One of the things that helps me to stay on top of technology is a habit I’ve developed of nosing around the Internet and reading things that are in my areas of interest.  Of course when you’re me, that sphere of interest can be pretty large at times which means I sometimes lose myself in a multitude of pages dealing with a multitude of subjects.  To my benefit (and hopefully your’s occasionally) I go “down the rabbit hole” and find some pretty interesting things.  Not always, mind you, but often enough that I feel it pays off.

Two or three years ago I happened to stumble across an article on Apple security and it introduced me to a Mac security researcher by the name of Patrick Wardle.  He is a pretty interesting guy and very familiar with the security of the Apple Ecosystem.  His bio states:

Patrick Wardle is a Principal Security Researcher at Jamf and founder of Objective-See. Having worked at NASA and the NSA, as well as presented at countless security conferences, he is intimately familiar with aliens, spies, and talking nerdy. Patrick is passionate about all things related to macOS security and thus spends his days finding Apple 0days, analyzing macOS malware and writing free open-source security tools to protect Mac users.

When I learned about Patrick, I also learned that he writes code for apps that help keep your Mac secure.  I’ve been using them religiously ever since and have been really happy with them.  Obviously someone with the background that he has means his coding skills have been very well honed.  I’ve been impressed enough with him to become a Patreon supporter.

I was also impressed to learn that Patrick created a meeting called Objective by the Sea that deals with Apple security.  The event is now entering its third year and for anyone who is interested in coding and the security of the Apple Ecosystem, this is a meeting that I really think you should consider.  While the event is still in the planning stages as far as the venue is concerned, you can get overview details from the website.  Put this one on your calendars now if Maui in March 2020 seems like a good idea (and really, why wouldn’t it be?)  

Tuesday, October 29, 2019

Healthcare Security Breaches Focusing more on Social Engineering


One of the ways I try to keep up on things is by a voracious reading habit.  I’ve always had a love of gadgets and technology, but keeping up with the constant onslaught of information can be challenging for anyone.  I think this is especially true if the subject happens to be one you don’t have a tremendous interest in.  It’s probably not necessary to say this here, but I take a great responsibility in keeping you abreast of as much tech information as I can.

To help, whenever I hear of a report being released I grab it and try to digest it in a timely manner.  One of the things about technology is that if you don’t stay current, you’re moving backward.  Then trying to get back to a level playing field knowledge wise is even harder.

The thing I love about reports put together by experts is that they summarize things they are seeing and it helps get the message out more succinctly.  So I was excited when I learned that ProofPoint had released a new healthcare industry report on security.

Something that everyone in healthcare needs to be considering is that this is not just something that requires attention because we are trying to be HIPAA compliant.  Don’t get me wrong on that statement. Being in compliance with federal law is *extremely* important.  HIPAA violations can lead to serious fines that could cripple or end the life of a small practice.  However, today it’s not *just* about laws.  Security flaws and the disasters they bring can have as big an impact on the financial well being of a practice as federal fines.  If Ransomware locks you out of your database, your organization begins to hemorrhage money.  Not only are you not generating revenue, you are also paying experts to try to reconstruct your systems from the ground up.

There is also the aspect of the care of the patients.  If a practice goes down, or more importantly a hospital, the well being of patients is immediately at stake.  Lives may hang in the balance and that gets back to the Hippocratic Oath of “First of all, do no harm.”  If a patient cannot be treated appropriately this can have disastrous results.  Security is not a “good idea”, security is now one of the major tenets of healthcare.

What experts like ProofPoint are now discovering is that criminals are not just looking for ways to break into systems by computer hacking techniques.  Recently they have turned to social engineering tactics as well.  Here are 5 things they point out in their report:

  • Targeted healthcare companies received 43 imposter emails in first quarter of 2019, a whopping 300% jump over the same quarter last year. Within affected healthcare companies 65 people were targeted by spoofed email, and 95% of those companies saw emails spoofing their own trusted domains.
  • Subject lines that included “payment”, “request” “urgent” and related terms appeared in 55% of all imposter email attacks.
  • 77% of email attacks on healthcare companies used malicious URLs.
  • Banking Trojans were the biggest threat to healthcare companies over the period of our research.
  • Factors such as access to critical data or systems, having a public facing email, can make anyone a highly targeted person.

The lesson here is to pay close attention to the social engineering aspect of security now more than ever.

To learn more about what ProofPoint has discovered, follow this link.

Monday, October 28, 2019

Axsys Dental's Versamill 5X400 wii be Arriving Soon

I’m very excited for the arrival of the Versatile 5X400 by Axsys Dental.  This is a truly game changing 5 axis dental mill that is capable of producing practically any type of appliance or prosthetic that a dental office could need or prescribe.

When I first say a demonstration of the 5X400 I was delighted to see the amazing results the device is capable of.  It can mill zirconia, precious metals, titanium, glass ceramics (including lithium disilicate), models, clear aligners, occlusal guards, bridges, crowns, and more.

For years now the milling aspect of CAD/CAM has been limited to single units.  Since the majority (around 80%) of prosthetics in general dental practices are done as single units, this hasn’t been an incredible limiting factor.  However, offices that enjoyed the single visit aspect of CAD/CAM really had no choice but to opt for laboratory fabricated prosthetics when it came to bridges, custom abutments, etc.  Now, with the 5X400 those problem have been solved.  The mill can cut single units out of the “blocks” that offices are used to, while also taking advantage of milling from “pucks” for long spans and full arch appliances.  

The unit destined for my office is currently going through it’s final quality assurance testing and will be arriving soon.  We’re excited to begin implementing the system and evaluating the results.

Here are some of the basics from the company:

  • 5-Axis dental milling center capable of 5-Axis simultaneous machining  including undercuts.
  • Closed-loop position control assures accuracy and eliminates frequent machine calibrations.
  • Machine wide variety of materials - including: zirconia, glass-ceramics, wax, Ultimate, titanium* & more.
  • Ideal for the production of bridges, copings, inlays, onlays crowns, models, and more— even titanium abutments*.
  • Long tool life and superior surface finishes due to extreme stability and minimum vibration.
  • Flexible universal fixturing for quick adaption to different materials and restoration types.
  • Integrated HSM machine control.
  • Open architecture design compatible with industry standard software for easy integration into a complete manufacturing solution.

Needless to say I’ll be posting here and on my social media channels as the evaluation continues.  If you haven’t yet followed me on Twitter of Facebook, these links will get you there.

Thursday, October 24, 2019

Sugary Fruit Drinks for Children are Over Consumed and Unhealthy Despite Package Claims of "Real, Natural, and/or Organic"


According to the University of Connecticut’s Rudd Center for Food Policy and Obesity, U.S. children are continually increasing the amount of sugary drinks they consume and this is leading to obesity and disease later in life.  

The problem is that many parents see, hear, or read advertising claims and believe the claims at face value.  In reality the median juice content is only 5% while the median sugar amount is 16 grams (which is 1.25 tablespoons).  That’s a whopping amount of sugar for a drink in a “kid size” bottle.

It’s easy for a parent to look at something that is “fruit juice” and assume that because it is “fruit” that it has to be healthy for their children.  

The study has some incredibly enlightening information, such as the following:

One serving of 11 of the children’s fruit drinks analyzed had more than 50% of the recommended amount of daily added sugar for children (i.e., >12.5 g), including many of the highest-selling brands (Capri Sun Juice Drink, Hawaiian Punch, Sunny D, and Minute Maid Lemonade).

As most of us have realized, there is an obesity problem in the United States.  Not only can this affect children while they are still children, but this can continue to impact them as they grow into adulthood.  Heart disease, diabetes, many other diseases have direct link to obesity.  Unfortunately, branding drinks with incredibly high sugar content as “healthy” is neither *healthy* or truthful.  The Rudd Center report has some incredible statistics and I feel it bears reading even if you are not a parent of young children.

Wednesday, October 23, 2019

Patient Appreciation Pancake Breakfast


This past Saturday, our office hosted our Patient Appreciation Pancake Breakfast.  We like to do this event from time to time and it’s always a great time.  Despite a cool and rainy weather front, we had incredible attendance.  Pancakes and sausages were provided by local favorite Chris Cakes who were flipping pancakes and cooking sausages in the parking lot.

One of the great things about our office is that we have a large comfy reception area as well as a conference room so, even though the weather was damp and chilly, folks were eating warm and dry inside the building as well as a few brave souls who munched outside.

We recently completed the paperwork to absorb the patients of another local office as Dr. Jim Williams decided to retire and has entrusted the care of his patients to us.  It was a great way for some of Dr. Williams patients to come by, meet the staff, meet the doctors, and get a chance to see the office.

There’s just something about pancakes to start a Saturday off right and this was no exception.  Thanks to everyone who came by and helped make the event a success.  The gang at the office absolutely loves what we do and we couldn’t do it without all the patients who trust their care to us.  We are truly honored.

Tuesday, October 22, 2019

EPA Amalgam Separator Deadline Looms in the Near Future...


Every dental office will need to have an amalgam separator installed and in service by July 14, 2020 as mandated by the EPA.  Those that do not face fines to bring them into compliance.

While there are several companies in the market, my personal preference is DRNA (Dental Recycling North America).  The company provides a cost effective and turnkey solution to the amalgam separator requirement.  I've been using them for the past 5 years and have been very happy with the service.

According to the EPA:

If improperly managed by dental offices, dental amalgam waste can be released into the environment. Although most dental offices currently use some type of basic filtration system to reduce the amount of mercury solids passing into the sewer system, dental offices are the single largest source of mercury at sewage treatment plants.
The installation of amalgam separators, which catch and hold the excess amalgam waste coming from office spittoons, can further reduce discharges to wastewater. Without these separators, the excess amalgam waste will be released to the sewers.
From sewers, amalgam waste goes to publicly-owned treatment works (POTWs) Publicly-Owned Treatment WorksA water treatment facility, as defined by Section 212 of the Clean Water Act, that is used in the storage, treatment, recycling, and reclamation of municipal sewage or industrial wastes of a liquid nature, and is owned by a municipality or other governmental entity. It usually refers to sewage treatment plants. (sewage treatment plants). POTWs have around a 90% efficiency rate of removing amalgam from wastewaters.  Once removed, the amalgam waste becomes part of the POTW's sewage sludge, which is then disposed:
in landfills.  If the amalgam waste is sent to a landfill, the mercury may be released into the ground water or air.
through incineration.  If the mercury is incinerated, mercury may be emitted to the air from the incinerator stacks.
by applying the sludge to agricultural land as fertilizer.  if mercury-contaminated sludge is used as an agricultural fertilizer, some of the mercury used as fertilizer may also evaporate to the atmosphere.
Through precipitation, this airborne mercury eventually gets deposited onto water bodies, land and vegetation. Some dentists throw their excess amalgam into special medical waste containers, believing this to be an environmentally safe disposal practice. If waste amalgam is improperly disposed in medical waste bags, however, the amalgam waste may be incinerated and mercury may be emitted to the air from the incinerator stacks.  This airborne mercury is eventually deposited into water bodies and onto land. 

Thursday, October 17, 2019

Dentsply Sirona World 2019 proves again to be the dental industry’s must- attend educational event


As three days of unparalleled
educational opportunities and thrilling entertainment options
came to a close, attendees left the Mandalay Bay Resort and
Casino in Las Vegas understanding why Dentsply Sirona
World remains the premier dental event in the world.

“With more than 100 Breakout Sessions, rousing General
Sessions, top-tier entertainment and lively social activities,
Dentsply Sirona World proved why there is no equal to the
Ultimate Dental Meeting,” said Vice President of Marketing
Ingo Zimmer.

Held Oct. 3-5, attendees filled enlightening education sessions
taught by the biggest names in dentistry, got hands-on with
the most innovative technologies and products on the trade
show floor, experienced once-in-a-lifetime private shows from
the awarding-winning Zac Brown Band, iconic comedian Jerry
Seinfeld and so much more!

Continuing educational courses were offered in 12 specialized
tracks, a record for the event. Attendees had no shortage of
incredibly high-quality learning opportunities when they
personalized their schedules to meet their needs.

The General Sessions kept attendees on the edge of their
seats with inspiring speakers, including Dr. Mike Skramstad, Dr.
Rebecca Bockow, Imtiaz Manji, Dr. Shalin Shah, Amy Morgan,
Dr. Lyndon Cooper and one of the world’s top digital
strategists, Brendan Kane. Additionally, Dr. Meena Barsoum
and Dr. Tarun Agarwal performed live dental procedures.

Per usual, Dentsply Sirona World offered its guests the chance
to experience celebrity entertainment in a personal setting.
One of the top digital strategists in the world, Brendan Kane,
captivated the audience with this talk, sponsored by VITA,
during Friday’s general session, while legendary comedian
Jerry Seinfeld kept them laughing with his standup and the
crowd couldn’t stop dancing during the Grammy award
winning Zac Brown Band’s private concert.

Two wellness activities allowed attendees to better both their
minds and bodies, as Ivoclar Vivadent sponsored a pirate-
themed fun run and Solea sponsored a yoga class. Attendees
were in a jovial mood wearing their best pirate-inspired
costumes, as they made their way along the beautiful Las
Vegas Strip during Friday morning’s fun run. On Saturday,
guests looked inward and found their Zen during the Yoga
Session with Tara Jae.

The Bucca(l)neers’ Bash gathering was the perfect end to an
amazing three days in Las Vegas. Guests put on their eye
patches and hit the dance floor to socialize with their peers.
From the rousing band, to the tasty drinks and amazing pirate-
themed costumes, this party captured the true spirit of
Dentsply Sirona World.

Wednesday, October 16, 2019

The ADA’s Petition to FDA about SmileDirectClub is Still Active


Smile Direct Club is starting to take on water.  Take a look at this:

SmileDirectClub shares tumbled 13% on Monday, bringing their one-month loss to 46%, after California Gov. Gavin Newsom signed a bill into law that includes key changes in the regulation of the company’s “teledentistry” business model.  (MarketWatch)

Not to mention this headline:

SmileDirectClub is now the worst unicorn IPO of 2019, down nearly 60% from its debut (CNBC)

As Technology Evangelist, I am all about using tech to make the world, and especially health care, a better place.  However, I want it done *responsibly*, and from what I’ve gleaned about Smile Direct Club, it doesn’t meet that standard.

To make things worse for SDC (although worse is a relative term) the ADA (American Dental Association) has announced that they are also strongly opposed to the SDA model of treating patients.  To briefly summarize, SDC provides clear aligners with no physical exam from a doctor.  While in a few cases this might be feasible, I have seen many more cases in my career where a patient wants straighter teeth without realizing there are many factors that can compromise treatment.  Things such as active dental decay, periodontal disease, congenitally missing teeth, etc can greatly impact orthodontics and should be addressed and treated before even considering orthodontics.  

Here is the ADA’s latest announcement regarding this:

The American Dental Association (ADA) believes the public has a right to accurate information concerning the status of its pending  citizen petition submitted to the U.S. Food and Drug Administration (FDA) about SmileDirectClub, LLC’s direct-to-consumer plastic teeth aligner business. SmileDirectClub’s (SDC’s) inaccurate public statements that the ADA’s petition has been “shut down” or “dismissed” may deter customers who have experienced clinical problems in connection with SDC’s aligner “treatment therapy” from reporting their negative experiences to the FDA. 

SDC’s public misstatements, including in its Oct. 4 press release, are apparently based on a May 30, 2019 letter from the FDA to the ADA. The letter, which can be viewed at the citizen petition landing page, did not reject or dismiss any substantive aspect of the ADA’s citizen petition. The FDA’s letter explains:

“We appreciate the information [the ADA] provided. Such information is often helpful for us to identify problems with marketed products and possible violations of the laws and regulations that we enforce. We take complaints seriously and we will evaluate this matter to determine what follow-up action is appropriate.”

The letter further explains that the FDA does not initiate enforcement actions on behalf of petitioners. Instead, the FDA reviews the submitted evidence and decides for itself what action to take. All substantive issues raised by the ADA’s citizen petition remain fully before the FDA at this time. The comment period for the public to address the petition and for the ADA to supplement the petition is open until Oct. 22 at 11:59 pm.

Further proof of the continuing pendency of the ADA citizen petition is SDC’s acknowledgement of it in the “Risks Related to Legal and Regulatory Matters” section of SDC’s August 12, 2019 S-1 filing with the U.S. Securities and Exchange Commission. Had the FDA dismissed the ADA’s citizen petition, there would have been no reason for SDC to mention the petition in its securities filing, and certainly not to identify the regulatory proceeding as one of SDC’s existing “risks.” 

The ADA submitted its citizen petition and a complaint letter to the Federal Trade Commission’s (FTC) Bureau of Consumer Protection out of concern for public safety and customer recourse in the event of negative outcomes from SDC’s orthodontic “treatment therapy.” Plastic teeth aligners are designated by the FDA as a Class II medical device requiring a prescription. The ADA believes SDC is placing the public at risk by knowingly evading the FDA’s “by prescription only” restriction.

In lieu of having dentists review patient dental records or perform any sort of patient exam (whether using teledentistry or otherwise) before prescribing orthodontic treatment, SDC instead requires customers to self-report their dental condition. As the ADA explains in its citizen petition, customer self-reporting does not meet the applicable standard of care because it does not satisfy a dentist’s requisite professional due diligence. Put simply, SDC and the small number of “SDC-affiliated” dentists have no way of knowing whether a lay consumer’s self-reported dental condition is accurate, informed, or true in any respect. 

Moving teeth without knowing all aspects of a patient’s oral condition has the potential to cause bone loss, lost teeth, receding gums, bite problems, jaw pain, and other issues. Despite these potentially serious outcomes, SDC requires its customers to hold the company harmless from any negative consequences, as the ADA points out in its FDA citizen petition and FTC complaint letter.

In addition to these public health concerns, the ADA’s letter to the FTC cited various SDC practices the ADA believes to be deceptive under section 5 of the Federal Trade Commission Act, including:

Informing purchasers they have recourse against SDC via arbitration, when the same document includes a “small print” provision obligating the customer to waive any and all rights the customer “or any third party” may have against SmileDirectClub.

Soliciting customers by claiming that SDC aligners will correct their overbite, underbite, and crossbite conditions, or their “extreme” malocclusion. But after customers complain about poor clinical outcomes, SDC invokes other documents stating that its aligners cannot treat bite conditions at all and can only treat mild to moderate teeth misalignment, not “extreme” misalignment.

Claiming that SDC customers receive the same level of dental/orthodontic care as actual dental patients, when in fact SDC and its affiliated dentists provide virtually no care and, contrary to its claims, SDC does not use teledentistry.

The ADA considers it our public duty to make the relevant regulatory agencies aware of these facts, so those agencies can be fully informed and consider whatever actions they deem appropriate.

The FDA’s MedWatch voluntary reporting form may be used by both consumers and health care professionals to report poor clinical outcomes associated with medical devices, including plastic teeth aligners. The FTC also offers consumers an online form to report complaints about unfair and deceptive business practices on its website.

Tuesday, October 15, 2019

Ultradent Launches a VALO Curing Light into Space!!! And You Could Get a VALO for Only $0.99


There are some amazing things about Ultradent’s Valo curing light.  One of the most incredible is how durable it is.

The device is made out of aerospace grade aluminum which is the same aluminum used to make satellites, rockets, and missiles.  With that in mind, the smart and adventurous people at Ultradent had a great idea for the device’s 10 year anniversary.  That’s right, the first Valors hit the market in 2009.  To celebrate, they decided to actually launch a Valo into space!  Interested in seeing just how they did it? They have posted a video to FaceBook that shows the launch and even a brief “chase” by a drone.  

It’s not the easiest thing to do, getting something into space, but if something was easy, then the smart people at Ultradent wouldn’t do it!  I know these folks pretty well and I can say that those people love a good challenge.

So, they actually created a box carrying GoPro cameras, a Valo, and a bobble head of founder Dr Dan Fischer and attached the contraption to a weather balloon.  From the front lawn of Ultradent World Headquarters in South Jordan, Utah, the package was launched.  As you can see from the photo above, the project worked pretty well!  I do not know the final altitude that was achieved, but in the photo accompanying this post, you can see the curvature of the Earth.

Now if launching a curing light into space isn’t enough… the company has also announced a contest.  If you can guess where the Valo landed, you will be the proud owner of a Valo curing light for only 99¢!!!  That’s right, you can get the best curing light currently on the market for less than a buck.  Here is the link for the contest.  

Monday, October 14, 2019

Lung Injuries Due to Vaping Continue to be Reported


As almost everyone has heard, there has recently been a significant number of people afflicted with severe lung injuries apparently related to vaping.

While the exact cause is yet to be determined, it definitely appears to be caused by e-cigarettes.  The CDC (Center for Disease Control) has been investigating.  At this point, the CDC is strongly advising against using any of these products.  Now that the problems have come to the attention of federal agencies the investigations are progressing as fast as possible.

Here is what the CDC has stated as far as what they have so far determined:

  • As of October 8, 2019, 1,299* lung injury cases associated with the use of e-cigarette, or vaping, products have been reported to CDC from 49 states, the District of Columbia, and 1 U.S. territory.
  • Twenty-six deaths have been confirmed in 21 states.
  • All patients have reported a history of using e-cigarette, or vaping, products.
  • Most patients report a history of using tetrahydrocannabinol (THC)-containing products. The latest national and state findings suggest products containing THC, particularly those obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers), are linked to most of the cases and play a major role in the outbreak.
  • Therefore, CDC recommends that you should not use e-cigarette, or vaping, products that contain THC.
  • Exclusive use of nicotine containing products has been reported by some patients with lung injury cases, and many patients with lung injury report combined use of THC- and nicotine-containing products. Therefore, the possibility that nicotine-containing products play a role in this outbreak cannot be excluded.
  • At present, CDC continues to recommend that people consider refraining from using e-cigarette, or vaping, products that contain nicotine.

Here is what is NOT known:

  • At this time, FDA and CDC have not identified the cause or causes of the lung injuries in these cases, and the only commonality among all cases is that patients report the use of e-cigarette, or vaping, products.
  • This outbreak might have more than one cause, and many different substances and product sources are still under investigation. The specific chemical exposure(s) causing lung injuries associated with e-cigarette product use, or vaping, remains unknown at this time.

Obviously the safest thing to do is to immediately discontinue use of e-cigarette products.  However, human nature being what it is, the practice will most likely continue for the foreseeable future.  If you or anyone you know uses e-cigarettes and experiences any symptoms, seek medical help immediately.

Thursday, October 10, 2019

Emsisoft Releases *FREE* Decryption Tool for Muhstik Ransomware


As we all know, having a strong and reliable antivirus program running on your computers is incredibly important.  Connecting to the Internet without a reliable antivirus is simply asking for trouble and not worth the risk.  However, many users simply opt for one of the “big boys” of antivirus and don’t even consider alternatives.

The problem with some of the more well known AV programs on the market  is that they are rather process intensive.  This means they can sometimes slow your system down considerably.  The good news is that you are protected, the bad news is that your computer takes considerably longer to accomplish tasks.  Some of these AV suites also insert themselves so deep into your system that trying to removed them is almost impossible.  That means if you ever decide to go with another company, you may be unable to uninstall the current program.

That’s why I recommend researching and evaluating multiple vendors and not simply going with a company because everyone has heard of them.  There are several companies that provide very strong and reliable AV protection for a lower cost and don’t take over your system.

Some of these companies were started by individuals with strong backgrounds in Internet security and they continue to do research into security problems and even offer solutions.  One of those companies is Emsisoft.  The company provides a very robust and reliable AV suite that is rock solid and affordable.

I also love the fact that the company is giving back to the security field.  As you know, a lot of my interests lately have been focused on security and trying to help readers avoid that ravages of Ransomware.  Emsisoft recently released a FREE decryption tool for the Ransomeware variant called “Muhstik”.  For those affected by it, short of paying the ransom those affected don’t have much choice.  However as a way to help those affected, Emsisoft released the software at no charge, simply because helping is the right thing to do.

If you’ve been affected by Muhstik this is great news.  For those of you looking for a terrific AV product and would like to support a company committed to helping the industry, take a look at Emsisoft.

Wednesday, October 9, 2019

New Mid-ClassProsthetic Teeth LineDelivers Unprecedented Blend of Aesthetics, Easy Handling , Versatilityand Value


Kulzer’s Delara universal tooth line represents a new go-to option for labs

Kulzer, a global leader in dental materials,has announced the launch of its Delara tooth line, which sets a new standard for mid-priced prosthetic teeth by delivering modern layering, natural aesthetics, and easy handling. Like Kulzer’s Mondial, Mondial i, Artic and Basic prosthetic tooth lines, and in keeping with the company’s long-standing tradition of in-depth cooperation with dental professionals, the Delara line was developed by dental technicians for dental technicians.

Coming to market in the fourth quarter of 2019, Delara features 16 VITA shades and2 bleach shades (BL2 andBL3) in an optimized portfolio to meet universal needs. Its unique surface structure allows for natural light shattering and provides modern shading,as opposed to the dull appearance of some prosthetic tooth lines. Due to its easy processing characteristics, even dental technicians who make corrections can rest assured that Delara’s aesthetics and lifelike effect will not be lost. The teeth provide for lively transparency and successfully manage to avoid the undesirable grayor yellowish effect that can occur in the mouth with other products.

One tooth line that meets virtually every need

In addition to being visually impressive, Delara teeth offer a natural feel and excellent functionality. Technicians will appreciate the easy processing, while lab owners will appreciate great versatility and value. Dental labs that use it as their go-to line of prosthetic teeth will find that they are able to complete the majority of their restoration work more efficiently –with less need for grinding to adjust the shape –while still delivering quality restorations.

Dental laboratories will appreciate Delara’s many benefits, including:
•Beautiful, lifelike aesthetics:Modern, bright shading, dynamic light refraction from the vivid surface structure and anatomical forms give Delara a vibrant and fresh appearance.
•Easy handling for enhanced productivity:Simple setup with a polishing buffer,a basal grinding reserve, optimized incisal edges and reduced cusps for easy interlock create added efficiency and predictability for busy labs.
•Versatility:Various setup possibilities (from tooth-to-tooth to cross bite), CAD/ CAM production for easy integration into digital workflows,and great functionality meanDelara delivers as a universal, go-to line of prosthetic teeth.
•Excellent value:Agreat price-to-performance ratio that sets a new standard for prosthetics in the mid-priced segment–all with Kulzer quality and the excellent durability and comfort that patients can enjoy for a lifetime.

Due to its easy processing characteristics, even dental technicians who make corrections can rest assured that Delara’s aesthetics and lifelike effect will not be lost,” said Obie Clifford , Kulzer Product Manager.“The teeth provide for lively transparency and successfully manage to avoid the undesirable gray or yellowish effect that can occur in the mouth with other products.”

A rich history of prosthetic tooth innovation

A manufacturer of dental acrylics since the 1930s,Kulzerhas developed a tradition of quality, reliability, excellent aesthetics and innovation unmatched within the field of dental prosthetics. The company is particularly renowned for its expertise in balancing optimal functionality with the highest aesthetics.Kulzer prides itself on listening closely and regularly to its customers in order to ensure that its products perform exactly as dental technicians, dentists and their patients expect. To that end, the company develops all of its denture products, including its new Delara line, in close collaboration with internal and external dental technicians.

Tuesday, October 8, 2019

Ransomware Forces California Medical Practice to Cease Operations


For the last couple of years now I’ve been preaching the benefits of security from my pulpit of Technology Evangelist.

Some of you have reached out to me via electronic means to tell me basically “Flucke, I’ve got this covered.  I don’t need the expense of an outside service to run my backups.”  Honestly, I get that.  If you are a real die hard techie type, perhaps you have adequate systems in place.  The problem with these situations is that it’s hard to really be *totally* sure you have all of the systems in place because it is hard to predict what problems you’ll face and how many backups you might need to overcome that situation.  That’s why I’ve always referred to backups as “a backup chain”.  Simply because you need as many links as possible and it’s hard to judge how many links you’ll need.  The golden rule is that you need “one more copy than you think you need”.

Today, let me tell you about a medical practice in California.  Wood Ranch Medical, located in Simi Valley, California suffered a Ransomware attack on August 10, 2019.  While not many details on the attack and the ensuing restoration efforts have become public, this much is known.  The attack immediately encrypted the servers, the patient records, and the backup hard drives.  Evidently over a month was spent trying to fix the problem to no avail.  On September 18, 2019 the practice announced on their website that they could not recover the data and with the backup drives also encrypted they cannot rebuild the medical records.  Basically every piece of data was lost.  Since there is no data left to run the business with, Wood Ranch announced they will be closing the practice permanently as of December 17, 2019.

You read that correctly.  The practice was so devastated by the RansomWare that they are ceasing operations and are closing.  Without being aware of all of the things that transpired behind the scenes, it is difficult to know exactly what happened and exactly how it happened.  Looking back on this situation now, I would be willing to wager that what seemed like an unneeded expense for professional backups now seems like a bargain to the practice.  It’s like that with a lot of things.  Sometimes the price seems high until you are actually faced with the prospect, and the costs, of recovering.

I do not receive a check from DDS Rescue & I want you to know that.  I recommend them because I use them, I believe in them, and I know that they would have been able to get this practice back up and running, perhaps in as little as ONE day.  The money spent for their service should be looked upon as insurance.  RansomWare has stolen a doctors dream from them.  Don’t let this happen to you.

Monday, October 7, 2019

Mysterious iOS Attack Changes Everything We Know About iPhone Hacking


As most of you know, I take security very seriously and I try hard to get the rest of you to do so as well.  Sometimes my efforts are to protect patient data and keep practitioners out of trouble with enforcement entities.  However other times my efforts are to keep YOUR personal data out of the hands of nefarious types who will use it against you for God knows what.

*This is one of those posts.*  I have been exploring the subject of this post for a few weeks now through multiple sources and I have determined that anyone with an iPhone needs to be aware of this.  Wired magazine is not the only entity to be getting the word out, but I think the following article does a tremendous job.

Here is what Wired has posted.  If you are an iPhone user *this is required reading*!!!

Hacking the iPhone has long been considered a rarified endeavor, undertaken by sophisticated nation-states against only their most high-value targets. But a discovery by a group of Google researchers has turned that notion on its head: For two years, someone has been exploiting a rich collection of iPhone vulnerabilities with anything but restraint or careful targeting. And they've indiscriminately hacked thousands of iPhones just by getting them to visit a website.
On Thursday evening, Google's Project Zero security research team revealed a broad campaign of iPhone hacking. A handful of websites in the wild had assembled five so-called exploit chains—tools that link together security vulnerabilities, allowing a hacker to penetrate each layer of iOS digital protections. The rare and intricate chains of code took advantage of a total of 14 security flaws, targeting everything from the browser's "sandbox" isolation mechanism to the core of the operating system known as the kernel, ultimately gaining complete control over the phone.
They were also used anything but sparingly. Google's researchers say the malicious sites were programmed to assess devices that loaded them, and to compromise them with powerful monitoring malware if possible. Almost every version of iOS 10 through iOS 12 was potentially vulnerable. The sites were active since at least 2017, and had thousands of visitors per week.
"This is terrifying," says Thomas Reed, a Mac and mobile malware research specialist at the security firm Malwarebytes. "We’re used to iPhone infections being targeted attacks carried out by nation-state adversaries. The idea that someone was infecting all iPhones that visited certain sites is chilling."

This is just the first few paragraphs.  To access the rest of the article you NEED to follow this link.

Thursday, October 3, 2019

American Dental Association Expands Policy on Oral Cancer Detection to Include Oropharyngeal Cancer


As regular readers of the blog know, I’m extremely passionate about the detection of cancers of the head and neck.  Not only are these diseases life threatening, survivors are often left to deal with permanent disfigurement from surgeries.  For that reason, in my office every patient receives an oral cancer screening at every recare appointment.

The numbers dealing with these diseases are staggering.  Over 35,000 cases are diagnosed each year.  Of those diagnosed only 50% survive over 5 years.  More people in the United States die of oral and pharyngeal cancer than of cervical cancer.  Due to causation by the HPV 16 virus, those being diagnosed are young… many in their 20’s.  I could go on further, but I think you get the idea.  Dentistry needs to do all it can to help detect this threat at its earliest stages.

I’m a proud member of the American Dental Association and I am *really* proud of the organization’s stance and position on oral cancer.  At the most recent ADA meeting in San Francisco a few weeks ago the organization expanded its policy on the disease.  Here is the latest:

The American Dental Association recommends dentists conduct routine visual and tactile examinations for oral and oropharyngeal cancer for all patients, according to a resolution passed by the ADA House of Delegates on Sept. 9.

Resolution 65H-2019 amended the ADA policy on early detection and prevention of oral cancer to include oropharyngeal cancer and cover all patients, not just those previously thought to be at an increased risk because of tobacco and alcohol use.

"The revised policy aligns our statement with Centers for Disease Control and Prevention guidelines on visual and tactile examination and screening for oral and oropharyngeal cancers and highlights dentists' critical role in cancer screening and prevention," said Dr. Maria Geisinger, chair of the ADA Council on Scientific Affairs, which was charged with reviewing the policy and recommending changes.

The amendments also align with the ADA policy approved by the House of Delegates in October 2018 that supports the use and administration of the human papillomavirus vaccine. The CDC estimates 70% of oropharyngeal cancers in the United States are associated with HPV.

A research article published in August by the American Journal of Preventive Medicine found that in the 2011-16 National Health and Nutrition Examination Survey, only about one-third of U.S. adults 30 and older who had visited a dental practice within the last two years reported receiving an oral cancer screening exam.

In addition, survey data showed disparities based on demographics, with individuals who were a racial/ethnic minority, low income, less educated and uninsured or publicly insured less likely to be screened for oral cancer than those who were white and non-Hispanic, high income, more educated and privately insured.

"These patients are at a higher risk of developing oral cancer. The lower probability of dental professionals to screen these individuals represents a missed opportunity for early detection and improved outcomes of oral cancer," said Dr. Alessandro Villa, an assistant professor at the Harvard School of Dental Medicine and associate surgeon at Brigham and Women's Hospital, who co-authored the article and has worked with the ADA on HPV and oral cancer initiatives.

The disparities could indicate poor compliance with the current oral cancer screening guidelines and highlight possible selection of patients by dentists based on their socioeconomic status, but the findings also could be explained by some patient groups' lack of access to dental professionals with the time and training to provide oral cancer screenings, Dr. Villa said, adding more research is needed to understand the factors that limit an equitable delivery of the recommended screening.

"Every patient should be screened by their dentist and dental hygienist for possible early signs and symptoms of oral cancer, including the HPV-associated oropharyngeal ones," he said. "Efforts should be directed towards the education of patients about requesting an oral cancer screening in the dental office, and adequate training of the dental professionals on culturally sensitive communications might be an effective means to increase oral cancer screening exams among minorities and high-risk patients."

The full resolution will be available to members by the end of the year in the ADA Current Policies document at

Wednesday, October 2, 2019

Launching at Dentsply Sirona World 2019: The new Orthophos Systems


The new Orthophos Systems provide premium solutions for multiple applications, providing high image quality at a low dose, efficient and reliable diagnoses, and intuitive digital workflows. The Orthophos line offers a flexible solution for any practice to deliver treatment with confidence.

Charlotte/Bensheim, October 2, 2019: Improving treatment processes, optimal utilization of digital technologies, and the development of products and solutions that are adaptable to the individual needs of a dental practice, together drive innovation at Dentsply Sirona.

To better suit the needs of practitioners, Dentsply Sirona has introduced a new generation of tailor-made X-ray units: Orthophos E, Orthophos S, and the prized Orthophos SL- each providing a different range of features that allow the practitioner to image, diagnose, and treat (IDT) for higher case acceptance.

“With IDT, practitioners can expand their treatment procedures into implantology, endodontics, obstructive sleep apnea (OSA) therapy, and orthodontics,” said Javid Tokhi, Director of Equipment and Technology, “and with several enhanced features, the Orthophos Systems boast peace of mind to both the practice and the patient, ensuring confidence through accurate and fast scans.”

All Orthophos units work seamlessly with the award-winning Sidexis 4 imaging software and provide outstanding image quality with a low dose and optimal user comfort. Due to this diversification, the ideal solution is available to everyone, from new 3D users to experienced practitioners ready to maximize on all of the possibilities with 3D technology.

Orthophos E: The entry point into digital imaging

Orthophos E offers a smooth transition into the world of digital extraoral imaging for greater efficiency in everyday practice. With its panoramic, pediatric panoramic, bitewing and other exposure programs, the Orthophos E is equipped with all the basic programs for the 2D diagnostic process. Its MultiPad enables the selection of the program close to the patient. A motorized forehead and temple support serve to stabilize the patient while the integrated temple width measurement makes it possible to automatically select the appropriate orbital curve for outstanding image quality results.

Orthophos S: The versatile 2D/3D option

Orthophos S can be used as a pure 2D solution as well as a combined 2D/3D device. Thanks to the optimal cephalometric arm, it is also suitable for orthodontic practices. Orthophos S achieves reliable contrast in panoramic images with its autofocus function. The shape of the arch or the presence of dental anomalies must no longer be manually selected. The patented auto-positioner supports automatic positioning of the patient. Orthophos S is upgradable by adding the 3D option. It offers suitable volumes and modes for a variety of clinical indications, such as a focused high-resolution volume or a volume that displays three-dimensional information over the complete dentition with the dosage range of a 2D image. Various software packages are available to expand practice procedures, like implant, endo, sleep, and upper airway management.

Orthophos SL: The most versatile 2D/3D imaging system

Orthophos SL is the comprehensive diagnostic solution for digital imaging. The SL comprises a innovative range of equipment with the Direct Conversion Sensor (DCS) and Sharp Layer (SL) technology catering to all users with the highest requirements for panoramic and 3D imaging in their daily practice routine. The patented auto-positioner assists with automatically positioning the patient, thus enabling reproducible and perfectly positioned panoramic images. Depending on the clinical situation, extensive 2D programs and a range of volume sizes (Ø5cm x 5cm to Ø11cm x 10cm) in high definition (HD), standard definition (SD), and low-dose mode are available to the user. MARS (Metal Artifact Reduction Software) reduces artifacts for the best possible image interpretation by automatically detecting metals in each volume. Users can choose from 30 ambient light colors that provide background illumination, creating a comfortable, memorable space for your practice and your patients. The modern design was selected for a Red Dot Design Award and an iF Design Award.

"With the new Orthophos Systems, we have developed an offering that facilitates both the entry into the world of digital imaging and extensive use in offices practicing various disciplines," said Jörg Haist, Vice President Global Platform Management Equipment & Instruments at Dentsply Sirona. "This way, we can respond to the specific needs of our customers and even more dentists will have access to high-quality X-ray technology and thus to more reliable diagnoses and treatments."

Tuesday, October 1, 2019

The Best Pet Camera - with a Bonus!


If you are an animal lover, today’s post is for you!  In the world we live in, cameras are *everywhere*.  I recent article I read estimated that the average American is in front of a camera 50 times every day.

But what about out pets?  Well, with the proliferation of cameras, we now have the ability to keep track of our young children and even our pets via HD broadband enabled cameras.

One of the best I’ve seen lately is the Petcube Bites 2.  This little piece of tech wizardry lets you see your pet in 1080p and the camera has a 160 degree viewing angle which means if it is in a corner it will cover pretty much the entire room.  The sensor works in daylight, has night vision capability, zoom, and audio to allow you to talk to your pet.

However, the best feature in my opinion is its ability to toss your dog a treat directly from the device.  There is an app that gives you full control once installed on your phone.  Oh, and did I mention it is also Amazon Alexa enabled?  Maybe your pup can even order out for food...