Thursday, May 28, 2020

NSA Advises Citizens Being Targeted by Russian Military Hackers


It seems that the Russian hacker team known as Sandworm has been exploiting a vulnerability as long as the network is using an unpatched version of Exim MTA.  

NSA does not make announcements of vulnerabilities on a regular basis.  As a matter of fact, for years people humorously referred to NSA as “No Such Agency” due to its in incredible veil of secrecy.  However, when an exploit is discovered that creates mass potential for exploitation by persistent threat vectors, NSA will sometimes make the vulnerability known to help prevent its exploitation.

Today, the NSA did just that.  The idea, of course, is to get companies using unpatched software to run the updates and install the patches.  Thus it closes the holes that were being exploited.

Here is what the National Security Agency had to say:

Russian military cyber actors, publicly known as Sandworm Team, have been exploiting a vulnerability in Exim mail transfer agent (MTA) software since at least last August. Exim is a widely used MTA software for Unix-based systems and comes pre-installed in some Linux distributions as well. The vulnerability being exploited, CVE-2019-10149, allows a remote attacker to execute commands and code of their choosing. The Russian actors, part of the General Staff Main Intelligence Directorate’s (GRU) Main Center for Special Technologies (GTsST), have used this exploit to add privileged users, disable network security settings, execute additional scripts for further network exploitation; pretty much any attacker’s dream access – as long as that network is using an unpatched version of Exim MTA.

When the patch was released last year, Exim urged its users to update to the latest version. NSA adds its encouragement to immediately patch to mitigate against this still current threat.

For more information on this vulnerability and associated mitigations, review our Cybersecurity Advisory "Sandworm Actors Exploiting Vulverability in Exim Mail Transfer Agent. To receive notice of future cybersecurity product releases and technical guidance, follow our new Twitter handle @NSAcyber.

Tuesday, May 26, 2020

The CDC has *Finally* Updated Treatment Protocols for Dentistry


First of all, if you are reading this and involved in dentistry, you NEED to read the updated CDC Guidelines.  You can come back and finish reading my post after you’ve read through the pertinent info from the CDC.  The Guidelines are here.  

I’m sure that most of you like to keep bookmarks in your web browser for subjects or sites that you have an interest in.  That just makes everything so much easier.  I have a Bookmark folder called “Dental” and under it I have nested folders for things like “Pharmacology”, “3D Printing”, “Intraoral Scanners”, as others.  That way I don’t have to think or search online when I need to go to a site that has the information I need.

When the SARS-CoV-2 virus began to be big news in late February I promptly created a folder nested under “Dental” that I called “Covid”.  Information was changing so rapidly, that it greatly simplified my life to have all the important websites I was perusing on a regular basis available in a couple of clicks.  

One of the sites I bookmarked and kept in that “Covid” folder was the CDC page titled “Guidance for Dental Settings”.  When it comes to guidance on handling any type of infectious process from a clinical perspective I have always turned to the CDC.  The group has always been at the forefront on how to handle these types of scenarios and situations.

Yet, this time, CDC dropped the ball in a big way.  Now first let me state, that I understand the pressure that CDC is under.  They are being inundated with questions and requests from civilians, government officials, and every type of healthcare provider in the United States.  What they are being asked to do difficult.  They only have so many employees and some many hours in the day.  I am sure that their system is stressed to the breaking point on a continual basis.  I salute the job they have done.

However, at the same time I feel it is the right thing to do to evaluate the current situation and the mistakes that have been made, in an effort to improve things for the next pandemic situation.  And trust me when I say *next*.  There will always be a next when it comes to fighting diseases that affect the human race.

My complaint is the amount of time it took CDC to get us these updated guidelines.  In mid-March, the ADA had asked all dentists to cease treating patients for elective procedures.  The ADA promptly released a decision matrix with guidelines for what constituted a dental emergency so dentists could make informed decisions.  This was a threefold recommendation.  The first was to reduce chances for exposure and spread of the disease.  The second was to keep patients with dental emergencies out of hospital emergency rooms.  This kept ERs available to treat Covid-19 patients as well as reducing the risk of dental emergency patients contracting Covid-19 in the ER.  The third was to conserve PPE so that it was more readily available for hospitals and those treating Covid-19 patients.  The supply chain, by that time, was already stressed and the last thing needed was even more demand for N-95 masks, gowns, and the like.

Once dentistry, for all intents and purposes “shut down” everyone knew that eventually dentistry would “start up” again.  There was no doubt that when it *did* start up, things would be different.  The start up would need guidance on how to proceed with treatment.

An example of this can be made in my own dental office.  The city of Kansas City as well as the surrounding counties in Missouri and Kansas agreed to the same quarantine schedule.  Thus, I knew that my office would be opening for elective procedures on May 18th.  I began to plan for that opening several weeks in advance and began looking for guidance on how to keep my patients, my team, and myself safe.  Some offices, due to the quarantine schedule of their jurisdictions actually opened 2 weeks before I did.

Those that opened in the first week of May did so with NO recommendations from the CDC.  The ADA released their "Return to Work Interim Guidance Toolkit” on, I believe, April 24th, which was a week before many offices opened.  However there was no update on recommendations from the CDC.  In an attempt to get an update from the CDC, the ADA wrote a letter to the CDC requesting guidance.  This letter, dated May 6th, 2020 is addressed to Robert Redfield, M.D. who is the director of the CDC.  This letter was written the week that many offices were reopening.  At that point in time, the CDC guidelines were dated April 27th.

Dental offices continued to open.  They had no choice but to use their best professional judgement regarding how to treat.  On May 18th, my office reopened.  I had been seeing emergencies only since March 18th.  By that point in time, I had managed to stabilize as many patients as possible, but many of them required definitive treatment.  You can only provide palliative care for so long...

The problem was that on May 18th, the CDC still had not updated their guidelines since April 27th.

Finally on May 21st, nearly a month since the last update, CDC posted new and improved guidelines.  As a profession we depend heavily on the advice of experts when something outside the normal scope raises its ugly head.  I completely get the idea that SARS-CoV-2 caught the world by surprise, however an organization such as the CDC should shine in moments of crisis and confusion, but in this case they promoted confusion.

I’m afraid that as the world has changed and seemingly become more “blame oriented” no one wanted to accept the heat if something wrong was advised.  My hope is that smart minds at the CDC are already working on ways to improve their response in times of a crisis like this.  We depend on them and I support them.  I just don’t want this situation repeated in the future.

Monday, May 25, 2020

Pelton & Crane to End Operations after Over a Century of Sales & Service


When I set up my first office location, my dream was to have Pelton & Crane equipment.  For years P&C was the creme de la creme of dental equipment.  Everyone who knew the dental industry knew that if you wanted the Ferrari or Lamborghini of dentistry, you worked with Pelton & Crane.  Their equipment was state of the art (as much as it could be back then) and built like a proverbial tank.  Their products were amazing and they just didn’t break down.  When I moved out of my original location, I was forced (long story) to leave behind a Pelton & Crane “Chairman” dental chair and I was less than happy about that.

Around 2005 I remember rumors at the Chicago MidWinter meeting that P&C was going to be purchased by Danaher and rolled into their dental division.  I remember at the time being impressed with the acquisition.  Danaher had made a splash with their move into dentistry and purchasing Pelton & Crane showed that not only did they have money to spend but that they were interested in making sure the industry understood their devotion to quality.  Purchasing a company with a reputation like P&C ensured that the industry understood.

Unfortunately, change isn’t always guaranteed to be a good thing.  Sometimes changes bring with it unfortunate circumstances… this is one of those times.  After over 100 years of dental excellence, Pelton & Crane will be closing for new business.

I suppose the “good news” if there can be any out of this circumstance, is that because of the backing of having Kavo-Kerr Group behind you, the company will continue to provide customer support for the duration of customer warranties.  So often businesses close and leave their existing customer base high and dry.  It looks at this point that P&C customers will not have to deal with that.

It’s still a tough loss for the industry though.  Pelton & Crane was one of the industry’s shining stars, as a guy that gets to walk on both sides of the looking glass in dentistry, it’s sad to see them go.

Here is the announcement they sent out to the industry:

Closing for Business, Here for Support

For over 100 years, Pelton & Crane has been a partner and dedicated resource committed to our customer’s dental journey and ongoing success. Because we’re not an equipment company—we’re a people company. And for the next century to come, Pelton remains focused on helping to support our customers.

Our more than a century of dedication and innovation started in 1900 but it is with a heavy heart we announce that we will no longer be taking any orders as of May 22, 2020.

Along with this announcement, sales of all Pelton & Crane dental operatory equipment will be discontinued in the US, Canada, and all international markets and for all customer segments.

This includes Pelton & Crane's Spirit Dental Chairs, Spirit or Alliance Delivery Units, Helios Dental Lights and Pelton & Crane Cabinetry.

We will continue to service our current Pelton & Crane customers by honoring our 5-year warranty period and maintain inventory of Pelton & Crane service parts where possible for up to 7 years. Warranty service questions and concerns may still be directed to

Over the coming weeks we will transition our website to a support and resource center for existing Pelton & Crane customers. Here you will find information on service, use & care and installation support for Pelton & Crane equipment.

Thank you for being a valued Pelton & Crane customer and we appreciate you support throughout the years. 

Monday, May 18, 2020

Coronavirus (COVID-19) Update: FDA Informs Public About Possible Accuracy Concerns with Abbott ID NOW Point-of-Care Test


One of the few reliable (or so we thought) and easy Coved-19 tests available is the Abbott ID NOW.  Unfortunately now, well over 60 days into the pandemic here in the U..S., comes word from the FDA that the test might not be quite a reliable as first thought.  Here is the information staring from the FDA:

Today, the U.S. Food and Drug Administration is alerting the public to early data that suggest potential inaccurate results from using the Abbott ID NOW point-of-care test to diagnose COVID-19. Specifically, the test may return false negative results.

“We are still evaluating the information about inaccurate results and are in direct communications with Abbott about this important issue. We will continue to study the data available and are working with the company to create additional mechanisms for studying the test. This test can still be used and can correctly identify many positive cases in minutes. Negative results may need to be confirmed with a high-sensitivity authorized molecular test,” said Tim Stenzel, M.D., Ph.D., director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health.

The FDA is sharing early information available about potential inaccurate results in the spirit of transparency. The agency has been working with Abbott to analyze the information gathered to date and has worked with the company on a customer notification letter to alert users that any negative test results that are not consistent with a patient’s clinical signs and symptoms or necessary for patient management should be confirmed with another test.

The FDA looks at a variety of sources to identify and understand potential patterns or significant issues with the use of the Abbott test. No diagnostic test will be 100% accurate due to performance characteristics, specimen handling, or user error, which is why it is important to study patterns and identify the cause of suspected false results so any significant issues can be addressed quickly.
The agency is aware of some scientific studies that have identified accuracy issues with Abbott ID NOW and is investigating whether it could be due to the types of swabs used or the type of viral transport media (material used to transport the patient’s specimen). While there is important information to gather from these studies, it should be noted these studies have limitations, including small sample size, potential design biases, or tests that may not have been executed according to the manufacturer’s instructions for use, an important part of scientific research. This is why external scientific studies are one part of the FDA’s overall evaluation of a diagnostic performance.

The FDA has received 15 adverse event reports about the Abbott ID NOW device that suggest some users are receiving inaccurate negative results. The agency is reviewing these reports. It’s important to note that the adverse event reports the FDA receives from manufacturers, health care providers, health care facilities, and patients can be incomplete, inaccurate, or unverified, so agency staff must meticulously comb through the reports to identify crucial data to support any signals or patterns about device use.
Moving forward, Abbott has agreed to conduct post-market studies for the ID NOW device that each will include at least 150 COVID-19 positive patients in a variety of clinical settings. The FDA will continue to review interim data on an ongoing basis. The information gathered from the post-market studies can further help the agency understand the cause or patterns of any accuracy issues and inform any additional actions the company or the FDA should take.

The FDA will keep working with Abbott to further evaluate these accuracy issues and will publicly communicate any updates.

Thursday, May 14, 2020

CAO Group Announces PPE Product Line Aegis PPE product line available now for Dental Offices


The day that seemed like it would never get here has finally arrived.  Most dental offices will re-open on May 18th… at least here in the Midwest.  I know that Utah has been back to work for at least a couple of weeks while other states, like New Jersey, are still under quarantine guidelines.

However, whether you are ready to open or at starting to gear up, things in the dental industry have changed… drastically.  Offices across the country and now working hard to find the proper PPE (Personal Protective Equipment) to keep staff and patients safe from the continued threat of Covid-19.

This is a strange time in the profession.  As the supply chain struggles with shortages and counterfeits of trusted products, suddenly every office is ordering the same product as every other office and the supply chain is groaning under the stress.  Dentists need *reliable* PPE and it seems that even things like face shields are shoddily made and in short supply.  Wouldn’t it be great if a *trusted* name in dentistry could help with the supply problem?

Well help is here.  CAO Group, a company that has been making dental products for years has now announced the Aegis PPE line.  This is a new venture for CAO Group, but one I commend them for.  They’ve made a lot of great dental products over the years and when they saw the problems with PPE that dentists were battling, they were quick to jump in and help.  Here is the info on this new company:

The CAO Group, Inc. (CAO) announces both the launch and availability of their AegisTM brand Personal
Protective Equipment (PPE) product line to help dental practices come back to operation under COVID-19
pandemic conditions.

The Aegis PPE line consists of, but not limited to, the following items: Aerosol VacStation, Infrared
Thermometer, Coverall Suits, Protective KN95 Masks, Surgical Masks, Protective Goggles, and Face Shields.
Each product has unique features to protect staff in dental practices. Aegis VaStation features a three stage6
filtration and UV light with a flow rate of three cubic meter per minutes and low noise. The three-stage
filtration includes a moisture filter, a HEPA H13 filter for particles as small as 2.5um, an active carbon filter for
solvent and active particles. The UV light is 275nm wavelength of light intensity. Aegis infrared thermometer
are FDA cleared class II medical device and measure body temperature with no contact less than 1 sec. Please
visit and for details of products.

“Protecting office staff shall be the number one priority for dental practices” said, Densen Cao, PhD, Founder
and CEO of CAO. “Protections in dental practices must be advanced to a new standard under COVID-19
pandemic. Our recommendations for additional procedures for protecting dental staff are as follows: 1. Check
patient temperature as part of check in; 2. Use coverall suit, goggles, KN95 or surgical masks, and face shield to
protect staff during the procedures; 3. Use aerosol vacuum station to suck away aerosol during the procedures;
4. Disinfect routinely between patients.”

Aegis PPE products are available on,, and certain dental distributors.

About CAO Group, Inc.

Monday, May 11, 2020

Counterfeit N-95 Masks Begin to Enter Market - Buyer Beware


On Friday of last week, the New York Times published an article about the sudden influx of counterfeit N-95 masks entering the U.S. supply chain from our friends in China.

For those of you not well versed in mask terminology, at true U.S. certified respirator (even though it *looks* like a mask) has a snug fit and is referred to as an N-95.  Other countries have similar standards, but their names for the devices vary, adding to the confusion.  The China equivalent of the U.S. N-95 is called a KN-95.

Due to the global pandemic and the shortage of PPE (Personal Protective Equipment) that it created, the U.S. relaxed testing standards and was allowing KN-95 masks to enter the U.S. supply chain without testing.

About 3 weeks ago, some tests were performed and massive amounts of failures were noted.  This lead to the U.S. banning 65 of the previously approved 80 Chinese manufacturers.  Unfortunately because, for some unknown reason, the failures were not reported for about 3 weeks, that meant that these inadequate masks entered the U.S. supply chain and were put into circulation for healthcare workers on the front lines.  Basically that means that doctors & nurses were gearing up in these masks to go into rooms with patients known to have Covid-19, thinking they were wearing the best PPE they could get.

Why it took 3 weeks for the U.S. government to take action remains a mystery.

Thursday, May 7, 2020

Hawkeye Key Logger Comes Amid Pandemic Concerns


Not everything that you receive electronically dealing with Corona Virus fears is being sent to you out of concerns for your safety.  A recent spate of emails, in fact, is being sent in hopes of capitalizing on fears of safety.

It seems that recently emails are being sent that “appear” to be from the WHO’s Dr. Tedros Adhanom Ghebreyesus.  This email reports to be offering “drug advice” to unsuspecting users.  In reality what is being delivered is the Hawkeye Key Logger program. 

Key Loggers are named because they truly have the ability to record every key stoke entered into a computer and can then send this information back to whoever sent the malware in the first place.  It basically allows an unknown person to see everything that happens on the infected computer.  In addition to stealing keystrokes and sending them along, Hawkeye can also capable of stealing credentials such as user names and passwords from email accounts and web browsers installed on the computer

The secret to avoiding these types of programs and situations are the ones I’ve discussed before.  “Think before you click” is the best advice I can give.  If you do not open files attached to emails, you won’t have many problems to deal with… so don’t open files sent to you unless you can verify the person who sent them to you.

It’s bad enough that we have to deal with the Covid-19 outbreak without having to worry about scams associated with it.  Unfortunately, that’s the world we live in...

Tuesday, May 5, 2020

ITC Judge’s Initial Determination Rejects Align Technology Claims against the 3Shape TRIOS scanner


There have been rumblings lately about the lawsuit between Align and Trios.  It seems that Align had sued Trios for violating patents, among other things.

Today comes word that, at this point in time, 3Shape seems to be in the clear.  Here is the info:

3Shape today announced that the company has received a favorable Notice of Initial Determination regarding the 3Shape TRIOS scanner. The Notice of Initial Determination was issued by Administrative Law Judge MaryJoan McNamara of the U.S. International Trade Commission (ITC) following the ITC’s investigation of the complaint, filed by Align Technology, Inc. against 3Shape in December 2018, which is the third ITC case filed by Align against 3Shape

On April 30, 2020 Judge McNamara found that 3Shape did not commit any unfair acts in connection with the 3Shape TRIOS scanner as asserted by Align, ruling that there was no violation of the patents asserted against the TRIOS scanner. Thus, 3Shape will continue to sell, supply and service 3Shape TRIOS scanners in the USA.

“We are pleased that Judge McNamara rejects Align’s claim that the TRIOS scanner infringes any valid Align patents, like Judge Lord and Judge Cheney did in the two previous ITC cases launched by Align. Further, Judge McNamara found that one of the patents asserted by Align against TRIOS application software was invalid. This is a victory for innovation and the many dental professionals who every day apply innovative dental solutions to provide better dental care for their patients. We are confident that the ITC will follow Judge McNamara’s Initial Determination regarding the TRIOS scanner and its application software at issue,” says Tais Clausen, Co-CEO and Co-founder of 3Shape.

In her ruling, Judge McNamara reached an Initial Determination that certain claims of two other patents asserted against certain 3D model alignment methods when comparing a scan to a Virtual Ortho setup, as well as certain specific methods to align two 3D models in 3Shape’s Compare Model Sets ortho software module were infringed. 3Shape will seek the ITC’s review of this holding.

Innovation is the driving force behind 3Shape. 3Shape has always had the utmost respect for patents and intellectual property. We continue to create groundbreaking technology to advance dental care. That ability has made 3Shape a leader, which is supported by our more than 80 patent families and numerous industry awards.

3Shape will continue to do what we have always done: Work with companies (including competitors) to create exciting and innovative solutions that benefit labs and dentists and improve patient care.

Monday, May 4, 2020

U.S. Department of Labor Issues Additional Respirator N-95 Reuse Guidance


Here is the latest info on decontaminating high filtration masks for re-use.  This is through OSHA which is part of the Department of Labor.

WASHINGTON, DC - The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has issued interim enforcement guidance on reusing disposable N95 filtering face piece respirators (N95 FFRs) that have been decontaminated. The action marks the Department’s latest step to ensure the availability of respirators, and follows President Donald J. Trump’s Memorandum on Making General Use Respirators Available.
The guidance applies to workplaces where workers need respirators to protect against exposure to infectious agents that could be inhaled into the respiratory system, including during care of patients with suspected or confirmed coronavirus and other activities that could result in respiratory exposure to SARS-CoV-2, the virus that causes the coronavirus.
If respiratory protection must be used, and acceptable alternatives are not available for use in accordance with OSHA’s previous coronavirus related enforcement memoranda, the National Institute for Occupational Safety and Health has identified available research that suggests the following methods offer the most promise for decontaminating FFRs:
Vaporous hydrogen peroxide;
Ultraviolet germicidal irradiation; and/or
Moist heat (i.e., using an oven).
If the methods above are not available, microwave-generated steam or liquid hydrogen peroxide could also be suitable.
The following methods are not considered acceptable unless objective data that sufficiently demonstrate the safety and effectiveness of such methods become available:
Dry heat;
Isopropyl alcohol;
Dry microwave irradiation;
Chlorine bleach;
Disinfectant wipes, regardless of impregnation (i.e., chemical saturation); and/or
Ethylene oxide.
Employers should investigate the effectiveness of any particular decontamination method used for the specific filtering facepiece respirator model to be decontaminated. Employers should be able to demonstrate the effectiveness of any decontamination method used against the likely contaminant(s) (i.e., pathogens) of concern, and that the decontamination method used does not produce additional safety hazards.
This interim guidance will take effect immediately and remain in effect until further notice; however, this guidance is time-limited to the current public health crisis. Visit OSHA’s Coronavirus webpage regularly for updates.
For further information about the coronavirus, please visit the Centers for Disease Control and Prevention.
Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit
The mission of the Department of Labor is to foster, promote, and develop the welfare of the wage earners, job seekers, and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights.
 Occupational Safety & Health Administration
 April 24, 2020
Release Number
Contact: Department of Labor National Contact Center