All Posts byJohn Sarno DMD

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I am a native Floridian, grew up in Jupiter, Florida I graduated from the University of Florida College of Dentistry where I received my DMD degree in 2010.

Feb 21

Dental Implant with Slow-Release Medication Reservoir

By John Sarno DMD | Dental Treatments , John Sarno DMD

Researchers have developed a dental implant with a built-in reservoir for the slow release of drugs. This schematic presents it integrated into the jawbone and with a crown on the tooth.
Image credit: Kaat De Cremer, KU Leuven

The researchers, from various departments at KU Leuven in Belgium, describe how they designed and tested the implant in a paper published in the journal European Cells& Materials .

Lead author Dr. Kaat De Cremer, from the Centre of Microbial and Plant Genetics at KU Leuven, explains that the reservoir in the implant can be filled by removing the cover bolt.

” The implant is made of a porous composite material, so that the narcotics gradually diffuse from the reservoir to the outside of the implant, which is in direct contact with the bone cells. As an outcome, the bacteria can no longer form a biofilm .”

In general, bacteria have two life-forms. In one, the planktonic nation, they exist as single, independent cells, and in the other, they aggregate in a slime-enclosed mass called a biofilm.

Feb 21

Benefits of Meeting Children’s Dental Needs

By John Sarno DMD | Teeth Whitening

A report in The Journal of the American Dental Association( JADA ) shows that dental benefits play a significant role in satisfying the dental needs of children, including checkups and therapies. The analyze is especially timely as February is National Children’s Dental Health Month.

The report determines U.S. children enrolled in private or public dental care plans were more likely to receive dental care than children who did not have coverage from 1997 to 2014. The analyze also showed that unmet dental needs of children who were enrolled in a dental care plan, private or public, steadily decreased from 2009 to 2014.

” The number of uninsured children decreased by 58 percent from 1997 to 2014 with a significant change from private to public insurance coverage ,” stated writers Maryam Amin, D.M.D ., M.S.c ., Ph.D ., Maryam Elyasi, D.D.S ., and Zhou J. Yu, B.S.c.” The change toward use of public insurance along with a significant association between unmet needs and dental visits support the effectiveness of publicly funded programs in facilitating the use of dental services in the United States .”

The writers examined data regarding more than 65,000 participants collected by the National Health Interview Survey( NHIS ), which is conducted by the U.S.

Nov 07

Dentist-physician Teamwork Essential to Dental Sleep Medicine

By John Sarno DMD | Dental Treatments

This article first appeared in the newsletter, DE’s Breakthrough Clinical with Stacey Simmons, DDS .

As a dental sleep medication practitioner, my collaboration with sleep physicians allows me to provide the highest quality of care for patients who may not otherwise treat their obstructive sleep apnea( OSA ). It is estimated that approximately 25 million Americans suffer from OSA, and up to half of treated patients don’t adhere to continuous positive airway pressure( CPAP) therapy–leaving a significant therapy gap. Qualified dentists are uniquely positioned to work alongside sleep physicians to help shut this gap.

Teamwork between dentists and sleep physicians when offering oral gadget therapy is essential because OSA is a medical disorder. As dentists, the moment we broach the subject of sleep apnea with our patients, we are entering a medical surrounding filled with diagnosis requirements, medical insurance billing, potential medical liabilities, and more. Dental sleep medication is an exciting realm to be employed in and a vital service that dentists can provide, but it needs to be coordinated in tandem with a medical counterpart to be truly impactful. Additionally, the dentist must be prepared through education to use the proper protocols in order to be a valued part of a medical team.


For best dental care near Jupiter, try visiting John Sarno D.M.D.


The interdisciplinary approach for oral gadget therapy be compatible with research and has been reaffirmed by successful patient outcomes for years. In this model, the physician is principally in charge of the patient’s medical evaluation, diagnosis, and longer-term management, while the dentist plays a necessary and collaborative part of the therapy team.

There are two primary roles a dentist can play in helping address the growing outbreak of untreated sleep apnea in our society, each requiring a different level of education, skill, and involvement :

1. Identify at-risk patients : Dentists can and should be on the front line to identify patients with potential sleep apnea and sleep-disordered breathing. Because we realize patients routinely, dentists are well-positioned to pinpoint those who are at risk for OSA and refer them to a knowledgeable sleep physician for a consultation and possible diagnosis.

2. Treat with oral gadget therapy : Once a patient has been diagnosed by a board-certified physician, dentists who are competent in dental sleep medication can then treat individual patients with oral gadget therapy. Continued communications and teamwork between sleep physicians and dentists during follow-up visits are imperative to confirm efficacy and increase therapy success.

Without collaborative relationships with physicians, dentists’ efforts to provide an acceptable standard of care are compromised. For example, to fit an oral gadget without a proper medical evaluation commits patients a false sense of diagnosis, deterring them from pursuing a comprehensive quiz with a licensed physician. This seemingly innocuous action has the potential to increase patients’ vulnerability to the adverse health effects and comorbidities of OSA.

dental sleep medicine, obstructive sleep apnea, sleep apnea, oral appliance therapy Indicative of the necessary collaboration between qualified dentists and physicians, the American Academy of Dental Sleep Medicine( AADSM) and the American Academy of Sleep Medicine( AASM) released the first official joint guideline on oral gadget therapy in July 2015. The six evidence-based recommendations in the guideline elucidate the individual roles of the dentist and sleep physician to ensure an effective working relationship. This relationship involves collaboration from the beginning so that patients understand the process of diagnosis, therapy options, and the roles of their care providers. By accentuating the vital importance of this physician-dentist squad, the AADSM-AASM guideline establishes oral gadget therapy as a patient-focused solution that necessitates a multidisciplinary approach to successfully treat the growing OSA epidemic.

Partnerships between qualified dentists and physicians are not simply key for optimal patient care; they also increase the breadth of a dentist’s dental sleep medication practice. Many dentists–myself included–have been so successful with providing oral gadget therapy that it is now the sole service of their practice, allowing their business to grow and reach exponentially more sleep apnea patients in need of treatment.

Sleep physicians want to work with dentists who are educated about OSA and who understand the value of teamwork. I often hear complaints from physicians that they cannot find a local dentist who is qualified in the comprehensive therapy of OSA. To be an outstanding dental sleep medication practitioner, you must network and ensure that your abilities are known within the medical community. Ultimately–for the best medical interests of patients–the dental sleep medication model relies on a collaborative, referral-based concerning the relationship between a sleep physician and a dentist.

 

Nov 07

Dental Technology: Buying New Toys for Your Dental Office

By John Sarno DMD | Dental News

 

Breakthrough Clinical as Editorial Director Stacey L. Simmons, DDS, explains why she loves her new digital scanner and dental imaging, as well as what she looks for in buying a new piece of dental technology for her practice.

It’s clear that the digital and technological world has firmly induced its footprint in dentistry, and if you’re like me, you don’t want to get left behind. That clearly arrives at a price and again, if you’re like me, you have to study world markets for the most recent and greatest gadgets and gismos, assess your finances, and then decide whether to take the plunge and purchase said toy( s ). My colleague and co-editorial director, Dr. Josh Austin, is a specialist in dental technology.

Well, the most recent addition to my digital armamentarium has not frustrated. I recently bought the Carestream CS 3600 digital scanner. What do I like best? This part of dental imaging equipment didn’t transgress my budget, its small and easy to use, it integrates with my software( Eaglesoft ), it scans promptly, customer support is readily( and easily) available, my crown/ bridge and scanned denture instances come back quickly and accurately, there are no associated fees, I don’t have to mess with impression material, and my patients desire it! They get so excited about learning a scanned image of their tooth that can be flipped around on the screen–all of their friends only have to know about it. Talk about a win-win.

I’ve only been using it 2 months and I’ve not yet tapped into the full potential of the scanner, but that will come with time. Bottom line: I’m never going back to impression material.

Sleep apnea is something I’m trying to continually learn more about, and we’re fortunate to have the president of the American Academy of Dental Sleep Medicine as an author this month. Dr. Harold A. Smith writes about how we can bridge the gap between dentists and physicians when treating our sleep apnea patients. Teamwork is key to a successful

Retreat or apicoectomy ? What are the factors that we need to consider when a root canal is not successful? Dr. Michael Zuroff, an endodontist out of Michigan, is back to give us his perspective.

I know you’ll enjoy the pathology case from Ghana in West Africa. Give us your thoughts. You only can’t make this stuff up.

Happy fall, my friends!

Stacey L. Simmons, DDS - signature

Stacey L. Simmons, DDS
Editorial Director, DE’s Breakthrough Clinical with Stacey Simmons, DDS

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Nov 06

Anti-inflammatory versus Antibacterial – Treating Periodontal Cancer

By John Sarno DMD | Dental News , Dental Treatments

A lot has been written lately about managing the inflammatory aspects of periodontal disease. After all, it is the body’s inflammatory reaction that is causing hard and soft periodontal tissue destruction.

When a patient presents to the office with periodontitis, an anti-inflammatory protocol may be indicated. Another way of thinking about this is revealed, however, if we go further back in the disease process. What induces mobilization of the inflammatory reaction in the first place? Bacterial invasion of the gingival epithelial cells is the trigger that ignites the body’s immune-inflammatory reaction, which is accompanied by the freeing of enzymes that destroy the gums and bone.


John Sarno D.M.D. is a Jupiter Dentist Dedicated to his Patient’s Care


Using anti-inflammatory meds as part of the therapy plan appears to have virtue, but the primary objective should be knocking down the cause–namely the bacteria. How do we know how effective our bacterial reduction efforts were? We don’t unless we offer salivary testing both pre- and postop.

This is not rocket science, but sometimes the simplest answers are the most difficult to see.

 ‘Richard H. Nagelberg, DDS Richard H. Nagelberg, DDS , has practiced general dentistry in suburban Philadelphia for more than 30 years. He is a speaker, advisory board member, consultant, and key sentiment president for several dental companies and organizations. He lectures on a variety of topics centered on understanding potential impacts dental professionals have beyond the oral cavity. Contact Dr. Nagelberg at gr82th @aol. com .

 

Nov 05

TMJ Stem Cells Used to Mend Cartilage Tissue in the Joint

By John Sarno DMD | Dental News

Researchers from the Columbia University College of Dental Medicine have identified stem cells within the temporomandibular joint( TMJ) that can construct new cartilage and mend damaged joints.

According to the National Institutes of Health, up to 10 million people in the United States, primarily women, have TMJ agitations. Options for therapy currently include either surgery or palliative attention which addresses symptoms but can’t renovate the damaged tissue. Dr. Embree’s acquires suggest that stem cells already present in the seam “could’ve been” manipulated to repair it.

Cartilage helps to cushion the seams and allows them to move smoothly. The type of cartilage within the TMJ is fibrocartilage is also found in the knee meniscus and in the disc between the vertebrae. Because fibrocartilage cannot regrow or heal, gash or malady that impairs this tissue can be achieved through permanent disability.

Medical investigates have been working to use stem cells, immature cadres that can develop into various types of tissue, to renovate cartilage. Devoted the challenges presented by displacing donor stem cells, such as the possibility of rejection by the recipient, investigates are especially interested in finding ways to use stem cells already living in the body.

” The implications of these acquires are wide-ranging ,” said Dr. Mao,” including for clinical cares. They suggest that molecular signals that govern stem cells may have therapeutic have applied for cartilage and bone regeneration. Cartilage and certain bone defects are notoriously hard to heal .”

Dr. Mao is co-director of the Center for Craniofacial Regeneration at Columbia. His own study with stem cells has renovated teeth and the meniscus, the pad of cartilage within the knee joint, and the TMJ in 2003.

In a series of experiments described in the brand-new report, Dr. Embree, Dr. Mao, and their colleagues isolated fibrocartilage stem cells( FCSCs) from the seam and showed that the cadres can structure cartilage and bone, both in the laboratory and when implanted into swine.” I didn’t have to add any reagents to the cadres ,” Dr. Embree said.” They were programmed to do this .” And while some comings to renovating disabled tissue compel increment points or biomaterials for the cadres to germinate on, she memo, the FCSCs developed and ripened spontaneously.

Dr. Embree and her team also identified a molecular signal, Wnt, that saps FCSCs and effects cartilage deterioration. Introducing a Wnt-blocking molecule announced sclerostin into degenerated TMJs in swine energized cartilage increment and healing of the joint.

She and her peers are now searching for other small molecules that could be used to inhibit Wnt and promote FCSC growth. The suggestion, according to Dr. Embree, will be to find anti-retroviral drugs with minimum side effects that could be injected right into the joint.

Children with adolescent idiopathic arthritis can have stunted jaw increment that can’t be treated with existing medicines, Dr. Embree memo. Since the TMJ is a growth center for the mouth, the brand-new study is available through approaches for analysis these children and lead to a better understanding of how the mouth germinates and develops. While orthodontists currently rely on clunky technologies such as headgear to modify mouth increment, she lent, the findings could point toward ways to modulate increment on the cellular level.

Ultimately, Dr. Embree and her unit say the findings could lead to approaches for repairing fibrocartilage in other seams, including the knees and vertebral disc.” Those the different types of cartilage have differing cellular ingredients, so we would have to really analyze the molecular underpinnings regarding how these cadres are modulated ,” health researchers said.

This investigation was supported by awards from the National Institutes of Health( K99DE022060-01A, 5R00DE0220660, R01DE021134, S10RR027050, S10OD020056, and NO1-DE-22635 ).

 

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Nov 05

Injected mix of Bone-augmenting Agents Causes New Bone Growth in Mouse Jaw

By John Sarno DMD | Dental News , Dental Treatments

Researchers centered at Tokyo Medical and Dental University( TMDU) deliver a protein/ peptide combination using an injectable gelatin carrier to promote bone constitution in mouse jawbones

Tokyo- The part of the jawbone containing tooth sockets is known as alveolar bone, and its loss over term or following dental ailment may eventually result in tooth loss. While dentures can be used as a tooth substitution, the mechanical stimulation for the purposes of the dentures effects farther bone loss. An alternative and more permanent solution is strongly hoped for. Recombinant human bone morphogenetic protein 2( BMP -2) has been used to stimulate osteogenesis( bone constitution) in humen, but high levels can cause inflammation and tumor progress. Hence, workers such as peptide remedies for accelerating bone augmentation need to be developed, even in the presence of lower levels of BMP -2. Additionally, there are no known means of arousing regional bone augmentation without acting surgery.

The peptide OP3 -4 has been shown to inhibit bone deterioration and stimulate the differentiation of cadres( osteoblasts) that figure bone. Now, an international team centered at Tokyo Medical and Dental University has injected a gelatin-based gelatin carrying OP3-4 and BMP -2 into mice jawbones to provoke regional augmentation of bone all over the injection area. The examine was recently reported in the Journal of Dental Research .

Employ of this injectable gelatin-based gelatin to carry the workers avoids the need for surgical implantation and resulted in no expand or other such complications in the experimental mice. The investigates observed individual regions of increased bone mass all over the BMP -2+ OP3-4 injection area that was larger than that considered to be in mice injected with BMP -2 alone, or with other masteries. This mass too had a significantly higher bone mineral material and concentration

Microscopic examination revealed the deposition of calcified tissue (mineralization) throughout the newly formed bone of BMP-2 + OP3-4-treated mice.

“Mineralization of the outer region evidently took place before that of the inner region,” lead author Tomoki Uehara says (Image2). “We speculate that the size of the new bone is determined before calcification starts, and that OP3-4 plays an important role in making a regeneration site at the early stage of bone formation.”

Corresponding author Kazuhiro Aoki adds: “OP3-4 further enhanced the number of bone-forming cells induced by BMP-2 treatment, and greatly increased the expression of genetic markers of bone formation.”

Article: Delivery of RANKL-Binding Peptide OP3-4 Promotes BMP-2-Induced Maxillary Bone Regeneration, T. Uehara, S. Mise-Omata, M. Matsui, Y. Tabata, R. Murali, M. Miyashin, K. Aoki, Journal of Dental Reseach, doi: 10.1177/0022034516633170, published online 22 August 2016.

 

 

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Nov 05

Periodontal Disease Prevention: Identify Bacteria Through Salivary Diagnostics

By John Sarno DMD | Dental News , Dental Treatments

In his DentistryIQ blog, a Making the Oral-Systemic Connection, a Richard H. Nagelberg, DDS, says he has  a revolutionary idea: identify the bacteria in patients who don’t have periodontal disease.a He goes on to explain the ideal protocol for combatting periodontal disease and how you can begin to offer diagnosis and treatment in your practice use the information that is available regarding risk factors namely, salivary diagnostics.

The hallmark of prevention is to determine risk factors for disease and then to oversee those risk factors before the disease, provision, or occasion comes. This is why there is so much existing information regarding the risk factors for myocardial infarction. Periodontal canker is no exception. Identify the biggest risk factor for the periodontal disease–namely, the specific bacteria a patient keeps in his or her mouth–and then administer it with an antimicrobial etiquette before periodontal canker rears its unpleasant head.

Patients who have a strong family history of periodontal canker would be an ideal place to start. Since you can reasonably predict that these individuals have some degree of hoisted gamble for periodontal canker, why not catch out which oral bacteria they have? And the same for patients with gingivitis who have not yet changed to periodontitis. If the test shows very little bacteria at low levels, we are capable of concluding that, at this time, the patient is not at risk for the developed at periodontal canker, and vice versa. This just acquires sense.

 

Nov 05

Diagnosis and Treatment for Breakthrough Clinical Oral Pathology

By John Sarno DMD | Dental News , Dental Treatments

This article first appeared in the newsletter, DE’s Breakthrough Clinical with Stacey Simmons, DDS. Subscribe here.

Last month I presented the oral pathology action of a healthy 40 -year-old woman who presented with a six-year history of a recurrent anterior mandibular growth. She experienced no hurting but was ashamed of being seen in public. She had two prior surgeries to compensate the original precondition. When the lesion was previously removed it was small and asymptomatic. The first surgery was done six years ago and the second largest surgery two years after that. After the second largest surgery, individual patients decided to pursue herbal medication because the regular medication wasn’t relenting a definitive arise. She returned 3 years later with no improved and the current rendition.

 

These are my differentials:

  • Ameloblastoma
  • Fibro-osseous lesion
  • Fibrous dysplasia
  • Ossifying fibroma

Definitive diagnosis: Recurrent ameloblastoma of anterior mandible

Recurrent ameloblastoma is a rare, benign tumor of the odontogenic epithelium occurring much more commonly in the mandible than the maxilla. Although it is rarely malignant or metastatic, it progresses slowly and can cause severe abnormalities of the face and jaws. Ameloblastoma has abnormal cell growth, which easily infiltrates and destroys surrounding bony tissues.

Incidence rates per million for ameloblastoma globally: (1)

  • Black males: 1.97
  • Black females: 1.23
  • White males: 0.19
  • White females: 0.45

Treatment: Wide surgical intervention is required to effectively treat this condition. A bilateral hemimandibulectomy was done for this particular patient.

This article first appeared in the newsletter, DE’s Breakthrough Clinical with Stacey Simmons, DDS. Subscribe here.

Reference
1. Shear M, Singh S. Age-standardized incidence rates of ameloblastoma and dentigerous cysts on the Witwatersrand, South Africa. Community Dent Oral Epidemiology. 1978;6:195-199.

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Nov 05

Written “Report Card” Decreases Dentists’ Antibiotic Prescriptions

By John Sarno DMD | Dental News , Dental Treatments

Dentists are less likely to prescribe antibiotics after they experience a personalised report detailing their past prescription writing rates, according to a randomised restraint test of UK dentists published in PLOS Medicine , by Linda Young, NHS Education for Scotland, UK, Jan Clarkson, University of Dundee and Craig Ramsay, Health Services Research Unit, University of Aberdeen, and colleagues.

Dentists prescribe about 10 percentage of the antibiotics dispensed in UK community pharmacies. Previous considers discovered  that, despite clear clinical guidelines, they often prescribe antibiotics in the absence of clinical desire. To experiment an” audit and feedback” intervention to reduce these improper prescriptions, the RAPiD( Reducing Antibiotic Prescribing in Dentistry) test relied on dental prescribing and care claim data that was already routinely collected by the National Health Service. The investigates haphazardly allocated all 795 antibiotic prescribing general dentist rehearsals in Scotland( a total of 2566 dentists) to either receive or not experience a graph plotting their monthly antibiotic prescribing rate. A random subset of practices in the involvement group also received a written behavior change theme repetition national recommendations.

At the start of the test, the full amounts of the number of antibiotics prescribed per 100 NHS treatment declare were 8.3 in the limit group and 8.5 in the involvement radical. Over the 12 months following the start of the involvement, dentists in the limit radical rehearsals prescribed antibiotics at a rate of 7.9 per 100 declares, and dentists in the involvement radical rehearsals at a rate of 7.5, representing a 5.7% reduction in antibiotic prescriptions in the involvement radical relative to the limit radical. Additionally, dentists who received a written behavior change theme had an even greater reduction, of 6.1% relative to involvement dentists who did not receive such message.

While the findings suggest that accommodating individualized graphical feedback is coming from routinely collected data can reduce the antibiotic prescribing rate of dentists, it was not possible to evaluate the impact on the quality or appropriateness of dentists’ antibiotic prescribing in this study.

” The feedback provided in this study is a fairly straightforward, low-cost public health and patient safety intervention that could potentially help the part healthcare profession address the increasing provoke of antimicrobial opposition ,” the authors say.

This study was conducted as part of the TRiaDS program of implementation research which is funded by NHS Education for Scotland( NES ). The Health Services Research Unit which is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.

The columnists of this manuscript have the following competing stakes: Columnists LY and JEC are employed by NHS Education for Scotland, which is responsible for supporting NHS works in Scotland by developing and delivering education and training for those who work in NHS Scotland. Author AE was indicated that during the course of the study, “he’s in” paid full-time employment firstly by the University of Aberdeen and subsequently by Glasgow Caledonian University. The research was carried out on behalf of the TRiaDS Research Methodology Group( of which AE is a member ). This group provides funding for NHS Education for Scotland. No other competing stakes exist.

Article: An Audit and Feedback Intervention for Reducing Antibiotic Prescribing in General Dental Practice: The RAPiD Cluster Randomised Controlled Trial, Elouafkaoui P, Young L, Newlands R, Duncan EM, Elders A, Clarkson JE, et al ., PLOS Medicine , doi: 10.1371/ journal.pmed. 1002115, produced 30 August 2016.

Dentists are less likely to prescribe antibiotics after they receive a personalized report detailing their past prescription rates, according to a randomized controlled trial of UK dentists…

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