Wednesday, February 26, 2020

Why Does Bonding Fail in both Operative and Fixed Restorative Procedures?


One of the most frustrating problems in clinical dentistry is failures in bonded restorations.  Whether it’s a newly placed crown that simply doesn’t seem to want to stay in place or a simple 2 surface composite restoration with chronic sensitivity, bonding can be both highly predictable as well as the source of unending frustrations for the clinician.

There are several points in bonded system where failure can occur.  Things such as compatible chemistries, bonding agents, the choice of total etch vs. self etch, and curing lights can all have a dramatic impact on the outcome of procedures.

Over the years, despite the development of newer bonding systems, I’ve stayed with the 5th Generation technique.  This is the technique where a total etch of both enamel and dentin is done, followed by a dentin primer and bonding agent in a single step, followed by placement of the composite.  This technique has loads of research and has also proven to provide very good bond strengths.  This technique can be used in both operative and when bonding fixed prosthetics with pretty predictable results.

In the latest issue of Dental Products Report my good buddy Laura Dorr had done a terrific article detailing the fine art of "Picking up the pieces when a dental restoration fails”.

She interviewed myself and other doctors on how we troubleshoot problems that *every* dentist has at one point or another.  Laura is very talented writer and I feel that anyone who practices dentistry should give this article a look.  You can find it on the DPR website.  

Tuesday, February 25, 2020

Kavo Announces Release of new Intraoral Sensor - Kavo IXS


The company Kavo-Kerr has a long history of incredible products.  Over the years I’ve told readers and audiences that I consider the company to be the manufacturer of some of the best products in the profession.  There are several companies under their product umbrella… including Gendex.

This new sensor is the successor to the Gendex GXS-700 sensor which I have been using in my practice since before they were released.  AAMOF I have the honor of being the first office in the US that used the GXS-700 sensor.  I can tell you from personal experience that the image quality of the platform is tremendous.

Now comes the next generation of these amazing sensors.  Here is what the company has to say about them:

 KaVo Imaging unveiled an all-new addition—KaVo IXS –  to its sensor portfolio at the 2020 Chicago Midwinter Dental Meeting.

KaVo IXS intraoral X-ray sensors come to fruition after years of product development and customer feedback. “We incorporated the successes from our line of Gendex sensors and added customer requested enhancements,” said Jordan Reiss, Director of Product Management, KaVo Imaging, North America. “We are proud that the new KaVo IXS sensors are more durable, automated, and reliable than many other sensor options available today.”

KaVo IXS size 1 and size 2 sensors feature KaVoTough™ engineering in both the sensor and the cable which were thoroughly tested to surpass Gendex GXS-700 sensors in both strength and durability*:

  • KaVo IXS sensors are 3 times more resistant to damage or functional failure than GXS-700
  • KaVo IXS can withstand double the biteforce without cosmetic damage than GXS-700
  • The KaVo IXS cable can withstand over 240,000 bend cycles
  • The KaVo IXS cable can also withstand 22 lbs. of force without functional failure

Like Gendex GXS-700, KaVo IXS sensors have open architecture software capabilities. Seamlessly integrate KaVo IXS, without the need for a bridge or any additional modules, into the most popular imaging and practice management software, such as: DTX™ Studio, DEXIS™, VixWin™, Cliniview™, Dentrix Ascend, Eaglesoft® Advanced Imaging, and Apteryx.

KaVo IXS also includes automatic software updates, direct-download calibration files inside the sensor, and IoT capabilities for proactive sensor health monitoring.
With exceptional image quality, two ergonomically designed sizes, and a no-questions-asked, unconditional replacement warranty, KaVo IXS is guaranteed for quality. To learn more or see a demonstration in your office, please visit or call 888-ASK-KAVO.

Monday, February 24, 2020

Ultradent's Gemini Laser Gets Upgrade with Photobiomodulation Tip

One of the things that has always fascinated me about lasers is how they can perform procedures that offer almost no post operative pain.  During my over 20 years of laser usage, I’ve done some fairly extensive soft tissue surgeries that have been painless.  At first I was stunned, but now I expect it.  Lasers also have the proven ability to decrease inflammation and pain response in tissues that have undergone some type of injury.

When tissues have been injured, exposing those areas to laser energy has a profound affect resulting in decreasing the negative aspects of inflammation.  This is referred to as photobiomodulation (PBM).

Now comes word from Ultradent that their Gemini laser can be fitted with a PBM tip which diffuses laser energy per square millimeter and places it over a larger area.  Here is what the company has to say:

The Gemini Laser Just Got Better
The Gemini laser now has a PBM adapter, allowing you to offer pain management therapy for TMJ and other discomfort your patients may experience. Photobiomodulation (PBM), or low-level laser therapy, is a non-invasive photo-chemical reaction where light energy of a certain wavelength, intensity, and duration is absorbed at a cellular level, improving local circulation, oxygenation, and enzyme activity. It has been clinically tested and shown to help improve tissue repair and reduce pain and inflammation. It’s a new way to take even better care of your patients.

Gemini™ PBM Adapter
The Gemini PBM Adapter Kit allows clinicians to offer pain management therapy during a laser procedure through photo biomodulation (PBM). Light energy is absorbed at a cellular level, improving circulation, oxygenation, and enzyme activity.

Kit includes:
PBM Adapter
Software update—adds “Pain Relief” preset under “Hygiene”
Single use spacer tips (2)
Handpiece holder clip
Cleaning cloth
User manual

If you are interested in purchasing the PBM adapter, this link will take you there.

Benefits of PBM include:
  • Temporary Pain Relief
  • Improved Local blood Circulation
  • Relaxation of Muscle
  • Decrease in Inflammation
  • Faster Healing
  • Improved Cellular Function, especially in Stressed Cells

Tuesday, February 18, 2020

At CDS 2020: Owandy Radiology Debuts 5-Year Warranty Program that Covers Complete Product Line


Owandy is a company that makes high quality imaging equipment.  Over the years I’ve been impressed and *continue* to be impressed with the incredible lineup of products that company has brought to market.  Now comes a little something extra - a 5 year warranty.  I always know a company has serious belief in their products when they extend the warranty and this is no exception.  Here is all the info:

Owandy Radiology Inc., a global leader in the manufacture of dental radiology hardware and imaging software, will be introducing
its new 5-year warranty program during the Chicago Midwinter Meeting in booth #4821.

According to Owandy company spokesman Boris Loyez, “We’ve extended our standard 2-
year warranty to 5 years with no additional upcharge to provide our customers with
additional value and peace of mind. Our 5-year warranty includes our entire product line,
including the I-Max 3D Cone Beam Unit, which is now our best seller since its recent
upgrades which included improved face scanning and airway imaging, which support the
rapidly growing segment of dental sleep medicine.”

In addition to the I-Max 3D, the Owandy 5-Year Warranty provides optimal protection to
the following products:

  •  Owandy I-Max Digital Pan Unit
  •  Opteo Digital Sensors
  •  Owandy-RX X-Ray Generator
  •  OwandyCR Plate Scanner System
  •  Owandy-Cam and Owandy-Cam HD Intraoral Cameras
  •  The Owandy 5-Year Warranty will be in full effect during the Chicago Midwinter Meeting and covers Owandy parts and service.
  • Repairs are performed by Owandy’s network of local distributors.

For more information about the Owandy 5-Year Warranty Program, and other Owandy
Owandy Radiology Inc.
124 Gaither Drive, Ste 140
Mount Laurel, NJ 08054
+1 203-745-0575
innovations, visit, call 203-745-0575 or e-mail at Distributor inquiries are always welcome.
About Owandy Radiology, Inc.:
Headquartered in France, and serving North America from Mount Laurel, New

Monday, February 17, 2020

Security Briefing for Small Businesses - Courtesy of Sprint


As you all know by now, I have a passion and perhaps a mild case of ADD when it comes to cybersecurity issues.  I’ve got lots of reasons for this, but one of the biggest is that it’s the right thing to do.

It also keeps your office out of trouble with the folks who enforce HIPAA regulations.  Security is one of the best examples of emergency preparedness.  If you prepare for an emergency, it won’t be an emergency when it happens.

One of the biggest problems in the world of cyber security is the “human element”.  Social engineering can make any of us vulnerable to giving up valuable data.  I’ve been coerced a few times myself, but those issues had nothing to do with my practice.  However, I am willing to gamble that if someone as paranoid about security as I am can be tricked into giving up info, you and your staff are probably vulnerable too.

Social engineering tricks are the easiest ways for cyber criminals to get inside your system.  Oh, of course they can also attack through brute force, but it’s SO much easier if you just give them the passwords yourself.  I was wandering the “Interwebs” the other day as I usually do and I found a great resource from Sprint on ways to protect your small business.  It’s so well written and provides so much info that I wanted to share it with you here.

I’ve been a Sprint customer since they first brought their mobile service to market and they are the only company I’ve ever used.  I thought I’d let you all know that as I the last stats I saw said that a 50% of mobile customers were dissatisfied with their providers.  Anyway, without further ado, here is the info courtesy of Sprint.  If you like to learn even more, you can follow this link.  

First, the bad news.

Small businesses are a big target for cyber criminals—even “I know everybody in my office by their first name, surname and the name of their dog/cat/goldfish” businesses.
No one is too small to pop up on a cyber criminal’s radar. Even though, as one report found, 54% of businesses believe they’re too small to be the target of ransomware.1 Unfortunately, this common assumption is a big mistake.

Why? Because even the smallest businesses have more money and valuable data to steal than a single consumer has—and also have a lot less protection in place than big businesses.

But what can you do about it? After all, without the money a medium-sized business has, let alone a big business, you can’t actually afford to protect yourself. Right?
This is another common assumption—and thankfully, this one is also wrong. The truth is that even very small businesses can put up a damn good defense against cyber attacks.

(That’s the good news.)

To start with, you need to know what to defend themselves against. With that in mind, here are the biggest threats facing (really) small businesses like yours in 2020—and what you can do about them.

1. Phishing
Phishing emails—which trick recipients to click on links they really shouldn’t click on—are the most common attacks out there. To make matters worse, they’re increasingly sophisticated and difficult to spot.
What to do: The key thing here is to educate your people in how to identify phishing emails. Happily for you, your team isn’t too big to train. Tools such as multi-factor authentication can help make it harder for phishing attacks to be successful—but ultimately your people are your first line of defence.

2. Ransomware
This involves a hacker getting into your network, encrypting your precious data and demanding that you hand over money in exchange for access. Small businesses are highly vulnerable to ransomware attacks because attackers know they’re more likely to pay up. Why? Because small businesses are much less likely to back up their critical data. They’re also more likely to be crippled by having their access to it blocked.
What to do: Don’t be one of those “we’re too small to back our data up” businesses. Look into backing up your mission-critical systems and data in the cloud. Today. (Right after you finish reading—and sharing—this blog, in fact.)

3. Malware
Malware comes in many forms (including spyware, trojan horses and “worms”). What these forms have in common is that they all contain malicious code designed to infiltrate, disrupt and damage your business. And small businesses are targets for all of them.
What you can do: Make sure your operating system, browsers and software are up to date to stay ahead of the hackers. There are also “as-a-service” solutions that can monitor all your internet traffic—you pay for such services per head, which makes them absolutely affordable for businesses of all sizes.

4. BYOD attacks
A BYOD policy makes a lot of sense for small businesses. It gives your people the option to work remotely on devices, without requiring you to pay for those devices yourself. But personal devices aren’t always subject to the same controls as company devices—especially in businesses without IT departments—which makes them potential trojan horses travelling into your business network.

What to do: What you need here is a mobile security solution that gives you “over-the-air” control of your employee’s devices. A solution like this will enable you to remotely monitor, manage and secure phones and tablets, automatically enforcing your security policies at all times and in all places.

5. Man in the Middle Attacks
These take place when employees connect to a public Wi-Fi network, thinking it’s legitimate, not realising that they’ve inadvertently connected to a fake network access point, set up by a hacker, who is now intercepting their (and your) data. Most of us now connect to public Wi-Fi networks with a degree of nonchalance, so it’s easy enough to fall for this.
What to do: A good virtual private network (VPN) service can be installed on employee devices and, having automatically detect an unsecured network, will encrypt all data and sessions taking place on it—leaving the man in the middle out in the cold.

6. Password attacks
In the era of cloud services, many of us are now using multiple passwords at work to access sensitive information. The temptation to use easy-to-remember passwords is ever-present. And easy-to-remember is easy-to-guess.
What to do: Education is a great start: impress upon your employees the importance of using strong passwords. You can also invest in password generation and management software.

7. DDoS attacks
A Distributed-Denial-of-Service attack is when a hacker uses malware infected devices to bombard your network (typically a website) with requests in order to slow it—or shut it—down. Downtime be disastrous for any business—let alone a very small one where every website visitor counts.

What you can do: As mentioned earlier, back-up your systems and files wherever possible in case of a DDoS attack. Ideally, though, you need to be able to detect and filter out incoming DDoS traffic. For businesses with modest budgets, cloud-based services that can be paid for on a monthly basis are available.

We hope this blog has given you some insight and ideas into how you can start protecting yourself. If you want more advice on how to approach security as a small business, why not check out our blog ‘How to establish your first security policies if you’re a small business’?


Thursday, February 13, 2020

Coronavirus and Infection Control Considerations for Your Dental Practice - Courtesy of Goetze Dental


I’m a huge fan of Goetze Dental here in the MidWest.  They are my preferred supplier and often it’s “the little things” that a business does for its clients that makes the difference.

As a company, Goetze is really good at communicating with clients.  The reps, the repair technicians (both dental and IT), and the folks at the order desk are all great at what they do and they do an amazing job of keeping my practice “in the loop” on a LOT of things.

Today I got another great example of this.  We’ve all heard endless amounts of information about the Corona Virus and the resulting fears of a pandemic.  Of course, in a situation like this one information is a powerful weapon… both to combat the disease and to combat the rumor and innuendo that surrounds a topic like this that is fraught with fear.  So today I was grateful to receive a large amount of useful information on the Corona Virus, Influenza B (which is hitting hard in this area of the US), and also infection control.  I was so impressed with this information that I thought it bears repeating here so that all of you world-wide can benefit from the information provided by Goetze Dental.  Here is the email in full:

Coronavirus and Infection Control Considerations for Your Dental Practice

With the quick pace of information and statistics emerging around the Novel Coronavirus (2019-NCoV), Goetze Dental hopes this will provide the basic facts around this infectious disease and remind your dental practice of the common infection control mistakes to avoid.

A Timeline of Events:
The world has watched a new virus emerge in the Wuhan Province of China, with the first confirmed case on December 31, 2019.  As the days and weeks passed, more people became infected with this novel respiratory illness. It was identified as the 2019 Novel Coronavirus (2019-NCoV), a new mutation of the Coronavirus that was also responsible for the SARS and MERS outbreaks in earlier years.

For the first weeks, public health and medical officials scrambled to find the origin and route of transmission of this virus to contain it (CDC, 2019).  On January 9, 2020, the first death in China was reported and the virus was determined to come from an open-air seafood market in the Wuhan Province. January 13 brought the first case outside China. This particular case was reported in Thailand and was one  of the first person-to-person transmissions of the virus. By January 18 there were 204 confirmed cases and three deaths related to the respiratory illness caused by 2019-NCoV. The cases continued to grow exponentially within China and the virus spread across the globe. January 21 we saw  the first confirmed case of the virus in the U.S., spiking fears among Americans (Ravelo, 2019).

The World Health Organization (WHO) declared a public health emergency of international concern on January 30 as more countries reported cases of the virus (Ravelo, 2019). The WHO is currently (as of February 10, 2020) reporting 40,554  confirmed cases of 2019-NCoV and over 910 deaths from 24 different countries. Of those cases, thirteen have been confirmed in the U.S. with no deaths in the U.S. reported (WHO, 2019).

A Clinical Dental Perspective:

With a global public health emergency and confirmed cases in the U.S., how concerned should a dental practice be about 2019-NCoV?  This question has been in the back of my mind as I’ve been following the breaking news every day for the last five weeks. While this international outbreak is a concern to the public and healthcare facilities that have the potential to treat infected patients, the risk to dental professionals SHOULD be very low.  The CDC is currently monitoring the situation in the U.S. and reports, “While person-to-person spread among close contacts has been detected with this virus, at this time this virus is NOT currently spreading in the community in the United States (CDC, 2019).”

A combination of infection control practices and office policies on treating patients who are showing symptoms of any sickness can be a powerful force when it comes to protecting your patients and yourself.  Compared to other outbreaks the world has seen, the 2019-NCoV carries a lower mortality rate of about 2% compared to the 10% mortality rate of the SARS outbreak and the 35% mortality rate of the MERS outbreak.  Another public health concern that is happening right now is the flu. The Influenza B strain is the worst this year with over 12,000 deaths for the season so far. This puts the outbreak the highest it’s been in 17 years (Ries, 2020). Dental practices should be more concerned with preventing the spread of Influenza than the 2019-NCoV at this point in time.  This is not to say that 2019-NCoV should not be watched, but we are in the midst of an active Influenza outbreak in the U.S. that we can help reduce.

As a former clinical dental assistant and dental assisting educator, I have experienced, been extensively trained on, and taught others about OSHA Bloodborne Pathogens Standards and CDC Standard/ Universal Precautions.

These guidelines give dental professionals the education and background needed to protect themselves, their patients and their community from the spread of disease.
States are required to implement OSHA Bloodborne Pathogens Standards or a replacement standard that exceeds OSHA’s requirements.  These standards are in place to protect employees and include things like Personal Protective Equipment (PPE), sterilization techniques and Hazard Communications Standards. The CDC Standard/ Universal Precautions recommendations are not required by every state on the same level. These guidelines are presented in the “Guidelines for Infection Control In Dental Health Care Settings” from the 2003 edition of CDC’s Morbidity and Mortality Report (MMWR) (CDC, 2003).  This document can be found through the link listed in the references section.

Dental practices following the OSHA Bloodborne Pathogens Standards and CDC Standard/ Universal Precautions for clinical care at a very high level should have no issues with the transmission of any disease, including 2019-NCoV. These guidelines are meant to break a link in the chain of infection and are successful in dental practices around the country on a daily basis. There are practices that successfully treat patients with highly contagious pathogens on a daily basis.  HIV/AIDS, Hepatitis B, Hepatitis C, Tuberculosis and Influenza are pathogens that dental professionals come into contact with during their careers, but transmission is halted if the OSHA and CDC guidelines are followed.

Common Infection Control Mistakes to Avoid:
Even the most seasoned dental professional can forget some of the guidelines that are thrown at them regarding infection control and prevention.  Here are some of the most common mistakes that take place in a dental office and how you can protect your patients and yourself at the highest level.

Masks: Masks should be worn securely fitted around the bridge of the nose and the chin with no gaps.  Masks should also be changed between EVERY patient, EVERY hour or when the masks become damp with breath, whichever comes first.  DO NOT wear masks under the nose, this does NOTHING to protect you. DO NOT wear masks under your chin out of the operatory or clinical treatment room, you’re just spreading germs!  DO NOT put used masks in your pocket to use later—you contaminate your pocket for the rest of the day and have the potential for cross contamination (CDC, 2003).

Gloves: Gloves should be well fitted to your hand; this prevents unnecessary tears and possible exposures.  ANY rings should be removed during clinical care and kept in a safe place to prevent unnecessary tears in gloves. Remember, A a ring is a fantastic breeding ground for all the gross things you come into contact with. DO NOT use petroleum products with latex gloves (if you use latex gloves at all); petroleum degrades latex and causes micro-holes that pathogens can penetrate.  You should not have long fingernails with any sort of polish, gel or acrylic on them; this is also an opportunity to cause unnecessary tears and a breeding ground for those gross things (CDC, 2019).
Hand Hygiene: It is important that you wash your hands or use an alcohol-based hand sanitizer between EVERY patient, and EVERY time you put on or take off gloves.  Alcohol-based hand sanitizer can be used if hands ARE NOT visibly soiled. If you can see it, wash it! Hand washing should be completed for a minimum of 20 seconds, focusing between fingers and under fingernails, these are the most commonly missed areas (CDC, 2013).

Surface Disinfection: An intermediate level disinfectant should be used to clean and disinfect treatment areas. These disinfectants are rated on how long they take to destroy Tuberculosis (ex: 1, 2 or 5 minutes).  ALL disinfecting procedures should include a preclean and a disinfecting state (Wipe, Wait, Wipe). This gets rid of the bioburden, even if you can’t see it, and allows the disinfection process to happen. Surfaces MUST remain WET for the recommended TB kill time to be effective.  Don’t set up a room if surfaces are still wet with disinfectant, let them work! Disinfectants that are on the market to the general public (ex: Clorox Wipes, Lysol Spray) ARE NOT recommended for use in a dental facility as they are not strong enough (CDC, 2003). Be cautious of the disinfectants that have a TB kill time of 1 minute and are alcohol based.  The concentrated nature of these disinfectants is very hard on equipment and can cause discoloration and cracking of plastics.

Sterilization: ANY instruments that are used intraorally must be disposable or HEAT sterilized between EACH patient INCLUDING HANDPIECES.  Ideally, sterilization pouches should be left in the sterilizer for the full dry cycle and only removed when the pouches are completely dry to prevent wicking of bacteria into the pouches.  Pouches that are not completely sealed or puncture should be repackaged and resterilized before use in treatment (CDC, 2003).

Proper OSHA Bloodborne Pathogens Standards and CDC Standard/ Universal Precautions can make all the difference in the world.  It is important that every team member has knowledge of these standards and is continuously evaluating the accuracy of them. It is common in offices for a team member, or even entire team, to lack the training required to effectively protect their patients and themselves.  Updates to the information through continuing education opportunities for ALL team members should be done on a yearly basis to keep everyone up to date on infection control. Help stop the spread of disease and get educated!!

Sarah Stream MPH, CDA, RDA, EFDA

Sarah Stream has been in the dental field since 2007.  Stream is DANB certified and holds an active Registration and Expanded Functions Certification for the State of Iowa.  Stream was a Clinical Dental Assistant for many years before becoming a Dental Assisting Educator and continues to promote education for Dental Professionals as a Private Practice Specialist for Goetze Dental.  She is active on the State and National level of the American Dental Assistant’s Association (ADAA), working to unite the profession of Dental Assisting through ADAA actions and activities. Stream recently received her Master’s in Public Health from Benedictine University, giving her an in-depth understanding of the public health aspect of dentistry and health issues on the global, regional and local level.

The views expressed in this article are those of Sarah Stream, informed by her experience and education outlined above.

Wednesday, February 12, 2020

Ultradent Extends Warranty of VALO Curing Light to 5 Years


The VALO curing light from Ultradent Products came to market in 2009.  That means (for those of you who are math impaired) that the VALO product line is now 10 years old.  That doesn’t really seem possible from my point of view, but hey as they say “temps fugit”.

Over those last 10 years, the VALO has pretty much become the Lamborghini of curing lights in dentistry.  The device didn’t invent the low profile design (which I affectionately refer to as the “toothbrush design)”, but it did pretty much perfect it.  Prior to the popularity of the VALO, the “gun style” curing light was incredibly common.  After the VALO that style pretty much disappeared.

Prior to the VALO, curing lights only had an output of 450nm which worked great for camphorquinone, but failed to work well with other photoinitiators in composites.  However, the VALO had LEDs in a “range” of wavelengths which meant that any material could be photopolymerized with the VALO.

The VALO has always had an incredibly powerful output and has only improved that over the years.  Stronger output means better depth of cure which translates to less post op sensitivity and longer lasting restorations.

Finally, the VALO has always been the most durable curing light on the market.  Before the VALO, curing lights were made out of injection molded plastic.  The VALO is machined out of aerospace grade aluminum in huge milling units located in the basement of Ultradent.  Drop a plastic light from a dental counter top and, if your are lucky, it will only chip or crack.  Worst case it shatters and no longer works.  VALO is made like a Humvee.  Drop it, it bounces, and it comes back for more.  It is the most durable piece of dental equipment on the planet.

From the company:

Every VALO light starts out as a single bar of tempered, high-grade aerospace aluminum, and is then CNC precision milled in our facility in Utah. This true unibody construction gives the VALO light superior heat dissipation and ensures that it is the most durable dental curing light available.

That durability and reliability has now made the news once again as Ultradent has just announced that they are extending the warranty of the Best of Class winning VALO to a never before heard of Five Years!!!  That’s right… not only is the VALO expected to last 5 years, if it doesn’t, it’s still under warranty.  How many products in dentistry have a 5 year warranty?  The answer is: not very many.

Tuesday, February 11, 2020

5 Reasons for Attending SureSmile 2020 in San Diego


SureSmile 2020 in San Diego is the ultimate user conference in digital orthodontics and a highly sought-after training and networking event. From February 27-29, attendees will have the opportunity to participate in workshops, case reviews, and software demonstrations while connecting with peers from all around the world. The clinical program covers an array of digital treatment sessions from aligner therapy to surgical simulations and addresses doctors and staff alike. To reserve a spot, orthodontic professionals are invited to register now at

Charlotte/San Diego, February 10, 2020. Once a year, users of SureSmile® aligners meet to redefine what is possible in digital orthodontics. The 3-day learning event is all about elevating SureSmile practice and has been at the forefront of the digital revolution for 15 years. These are the top 5 reasons for the great success and appeal of the meeting:

#1 Visionary speakers share their expertise

Mike Wittenstein, IBM Global Services’ former eVisionary, who led the company to its first projects in "customer experience design," will share his market-proven Storymining® Process which has contributed almost $2 billion for his clients. Renowned speakers like Dr. Alex Yusupov and Dr. Melisa Rathburn will cover virtually every case and treatment type: Class II to surgical, hybrid therapy, advanced diagnostics, robotically-bent wire design, 3D printing, aligner staging, cone beam and Primescan integrations, in-office fabrication, smile design, therapeutic photography, and much more.

#2 Outstanding educational content

Participants can choose from lectures, panels, and hands-on sessions delivered by SureSmile experts on biomechanics, aligner design, IDB, wire design, simulations, aesthetics, and more. Moreover, a variety of business topics are covered, designed to help grow and optimize the practice. SureSmile 2020 features three doctor tracks – advanced, ortho, and master classes – and one staff track. PreCon master classes for advanced SureSmile users, held on Feb. 27, offer in-depth hands-on sessions and talks designed to explore specific aspects of the digital practice. CE-credits are available for these classes.

#3 Numerous networking opportunities

The conference brings together doctors and staff from around the globe and features a program designed to provide various networking opportunities. Social events include a welcome reception, a costume gala, and a dinner/dance party which allows participants to meet and mingle in a fun and dynamic atmosphere.

#4 Digital Lab Consult

Participants can take advantage of an individual Digital Lab Consult at SureSmile 2020. In a 1.25 hrs. session, one of Dentsply Sirona’s skilled technicians will teach how to update and customize SureSmile settings to create the most efficient workflows in the practice. To book a convenient time, participants can sign up in advance at

#5 Inspiration for the entire practice

The SureSmile meeting is designed to promote staff skills that go beyond expertise in digital orthodontics. Staff classes include sessions on clinical techniques, role-specific expertise, and personal development. Staff can choose from lectures, panels, and hands-on sessions covering topics specific to their responsibilities. These include patient management, scanning, treatment coordination, building relationships with referring offices and patients, practice marketing and more.

For more information about SureSmile 2020 and for registration visit

Monday, February 10, 2020

Axsys Dental Solutions Versatile 5x400 is Now In Service


I’m proud and honored to say that our brand new Versatile 5x400 is now installed and in service.  This new state of the art piece of equipment allows us to perform a variety of restorative procedures and restore them with a much faster turnaround time than utilizing traditional fabrication pathways.  The milling technology aspect of dentistry has been around and in development since the late 1980s and early 1990s.  Needless to say, but in that amount of time a tremendous amount of progress has been made in the science.  Now, the stability and predictability of these devices has finally evolved to be on par with similar results created by human hands. 

We are excited to bring this incredible technology to our practice and we are looking forward to not only helping our patents, but to also help you terrific blog fans to learn and grow with us.

The 5x400 is a dental mill that utilizes subtractive fabrication technologies to allow us to create things such as surgical guides, crowns, bridges, occlusal guards, implant abutments, and much more with extreme precision and all done within the office.

  • 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.

The company has the following to say:

This purpose-built, Open Source 5-axis mill is designed to provide owners with maximum flexibility and versatility in a dental manufacturing system. The Versamill 5X400 can accept input from popular dental design programs and process virtually any dental milling materials including wax, zirconia, acrylic, composites, glass-ceramics and others.

The strength and rigidity of the Versamill 5X400 coupled with the undercut machining capability of full 5-Axis control provides superior surface finishes, faster cycle times and greater tool life while allowing you to machine virtually any material with the minimum amount of bench time.

Thursday, February 6, 2020

iTero Announces Updates to Platform for Existing Users


Here is big news for offices that are using/own an iTero intraoral scanner.  One of the incredible things about devices that are constantly Internet connected is that companies can make updates to these devices without any user intervention.  

This situation is so much easier than having to get the word out to every user to go to a dedicated page and download an update, install, and then run.  Now the software is updated when the device is idle and when you open the program, the changes have been made and the update has been run.

These situations also a great for the manufacturer because they can roll out the updates to a few users at a time.  That way if the worst case scenario happens and the update creates a problem, it can be rectified when it only affects a few users and not the entire user base.  In my career, I’ve seen mass distribution of an update create mayhem when a bug took every system offline and then the calls from users overwhelmed tech support (this was NOT iTero).  It took the better part of a week to rectify that problem.

So if you are an iTero office and have not received this email, you might check your spam folder or contact the company.  However, you won’t miss the email because I’m providing it for you here:

Dear Doctor,
Beginning February 6, 2020 the iTero team will begin a gradual rollout of new software features and enhancements on your iTero scanner and portal, including:
  • Automatic margin line marking
  • Removal of excess material
  • Editing patient details in MyiTero

Below please find all of the details. If you have any questions or need support please contact iTero support at 800-577-8767.
On Your iTero Scanner
Automatic margin line markingThe software will now automatically detect and mark the margin for restorative case types requiring crowns. After scanning, when you tap the margin line tool (highlighted in yellow in the image below), the 3D model display moves to the occlusal view and zooms in on the prepped tooth. A message is displayed, prompting you to wait while the automatic AI-based margin line is being detected. While in this mode you can manually change the margin by rotating the 3D image and touching and dragging the connection points along the green line. Note: only single crown indication is currently supported.

The Margin Line toolbar now includes an additional tool (outlined in the red box in the image below) that will enable you to create the margin line automatically if it is deleted.

Improved removal of excess materialRemove excess material in real time, during scanning, based on an AI algorithm.You can turn off the AI functionality for rare dentitions at your discretion. To turn off the functionality long press and hold on the iTero screen. A menu will appear, select "disable A.I. cleanup". Note: The algorithm does not support edentulous cases. Enhancements
Editing patient details in MyiTeroYou can now edit patient details in to ensure that the first name, last name, and chart number exist and are identical for a specific patient. This is to prevent the patient profile from being duplicated and information being lost. After synchronizing with the iTero scanner, the new details will be used in all applications and for all future cases.

If you have any questions about the use of these new features, please contact iTero support at: 800-577-8767.  We hope that you enjoy using these new improvements.
The iTero Team

Wednesday, February 5, 2020

Coronavirus Creates Mass Panic & is Leading to Surgical Mask Shortage


The Coronavirus has made lots of headlines since about mid-January.  It seems that every 2-3 years there is some type of a flu epidemic that causes panic across the globe (remember the H1-N1 scare?).

The outbreak of this cold & flu season is the Coronavirus which seems to have started in the Wuhan province of China.

As I type this, the virus has caused 494 confirmed deaths.  When you factor in the fact that the current world population is around 7.7 billion (7,700,000,000), the number of deaths is actually tiny in comparison.  However, if affects you or someone you love, statistics mean little.

In today’s environment of the constant input of the 24 news cycle, people are hearing a lot about the virus and its potential complications.  Because of that, fears are high of a global pandemic even though the possibility of that is actually pretty minimal.  With that being said, the Chinese government is actually requiring people in quarantined areas to wear surgical masks whenever they are in public.  This fact combined with the global scare and photos on every news story of people wearing masks has created a run on the mask supply.

There is also the fact that the majority of surgical masks are manufactured in overseas factories.  The US Department of Health and Human Services has compiled data showing the 95 percent of surgical masks and 70 percent of respirators are made overseas.  This means that as panic spreads, supplies get exhausted as frightened individuals try to purchase masks.  The interesting part of this, according to Business Insider is that "experts have said that face masks aren't necessary or even that effective — hygiene practices like handwashing and keeping a distance from people known to be infected will do — demand for the masks has reportedly exceeded supply in cities across the world."

The real problem could lie in the fact that healthcare workers who are the ones diagnosing and treating the patients with the disease may be at risk of running out of masks that they NEED to do their work and not become infected.

Companies selling masks to US healthcare providers have been advising for about a week that supplies are starting to show the strain and that they may not be able to keep up with demand.

This is an interesting Catch 22.  Healthcare workers may not have adequate supplies to treat infected patients which may lead to further infections and more deaths.

Update:  As an example, here is an email I received today from Henry Schein Dental:

Dear Valued Customer,
Due to the coronavirus outbreak, we are experiencing higher than normal demand globally for infection control products such as masks, goggles, and face shields, among other items. We are working with our manufacturing and supply chain partners, as well as global health organizations including the Pandemic Supply Chain Network, the World Health Organization, the Chinese Ministry of Health, and the Centers for Disease Control & Prevention, to address shortages as they occur. Given this situation and acute market needs, we anticipate disruptions to orders for certain infection products in various markets. Please contact your local Henry Schein consultant for specific inventory inquiries. 
Henry Schein Dental Customer Service

Tuesday, February 4, 2020

Congrats to Our Beloved Kansas City Chiefs!!!

On Sunday night, the Kansas City Chiefs became Super Bowl Champions for the second time in 50 years.  It's been a long rough road for the city, but now it all seems worth it.

The team beat the Minnesota Vikings in January 1970.  It was their second Super Bowl appearance in 4 years and the city was optimistic that there would be a few more in the not too distant future.  Unfortunately, that team was the best of the best and things quickly degraded after the win.

What followed was more than 2 decades of failure and horrendous football as well as horrendous  decision making by the front office.  Attendance plummeted and many games feature fans sitting in the stands with paper bags over their heads.

Then in 1989 Carl Peterson was hired as general manager and he promptly hired Marty Schottenheimer as head coach.  Even though the team never won a world championship under that regime, football greatness returned to Kansas City and the town responded with sellout crowds and a game day experience that has become legendary.

Since 1989 the Chiefs have seen some amazing success.  They have almost always been competitive and the city has maintained its love affair with the team.  The bad news is that despite many great teams and terrific seasons, the Chiefs have failed to win a championship.

Enter Patrick Mahomes.  Football is a game where a few great players in key positions can make a tremendous difference.  Mahomes is an incredible talent and the Chiefs have grown in domination along with him.

The other thing about Mahomes is his personality.  Although he is 24 years old, he conducts himself with the grace and personality of someone many years older.  His interviews are a study in maturity and grace.  Consequently, the city has fallen in love with him.

Throughout the years since the 1989 rebirth of the team, Kansas City has always lacked a young, great quarterback.  We've had some great ones (i.e. Joe Montana) but they were on the downside of their careers.  We've never had the opportunity to have a truly young superstar quarterback to build a team around... until now.

The city has embraced young Patrick Mahomes... and he has embraced the city.  Although I love my Royals, Kansas City is more of a football city.  This town has been salivating for a reason to celebrate a Super Bowl for decades now.  I'm proud to say that moment has arrived.

Thanks to the Chiefs for bringing the Lombardi Trophy to Kansas City.  You guys have made the city proud and we are excited to see the next steps in this journey!

Monday, February 3, 2020

Nine Members of the US House of Representatives Write FDA & FTC Regarding Smile Direct Club


As I discussed recently, Smile Direct Club has been in the news quite a bit lately, and not much of that news is good.  The purveyors of DIY orthodontics have been taken to task by The New York Times and other publications lately for trying to force unhappy customers to sign non-disclosure agreements in order to get a refund for poor services.

Combining that with the Better Business Bureau stating they have received 1796 complaints (so far) about the company, and things aren’t looking all that rosy for SDC

Now comes word that nine members of The US House of Representatives have signed a letter that was sent to the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) “to express their concern regarding SmileDirectClub.”  These members of Congress expressed their "strong support of the FDA and FTC investigating the practices of SmileDirectClub to ensure that it is not misleading consumers or causing patient harm." The signing members all have healthcare backgrounds - five dentists, three medical doctors, and one pharmacist. 
If I am SmileDirectClub, that news is a definite cause for concern.  When you have legislators that all have a healthcare background wanting you to investigated, that is not good news. 

All of this info is in the news thanks to the American Association of Orthodontists, a professional organization for those doctors specializing in orthodontics.

As I’ve stated recently, I’m no fan of do it yourself healthcare.  Anything that seems simple quickly becomes anything *but simple* when you actually try it.  Whether it’s wiring a new light switch or changing your break pads, or… moving your teeth, experience counts.  We are all born with a limited amount of teeth and if they are ruined, you don’t really get a second chance.

I’m all for making things easier and better, but not by eliminating the doctor from the equation.  SDC is in some serious hot water and the burner just got turned up… a lot!!!