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Dental Tribune U.S. Edition

HYGIENE TRIBUNE Tell us what you think! Do you have general comments or criticism you would like to share? Is there a particular topic you would like to see articles about in Hygiene Tribune? Let us know by e-mailing feedback@dental-tribune.com. We look forward to hearing from you! If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental-tribune.com and be sure to include which publication you are referring to. Also, please note that subscription changes can take up to 6 weeks to process. forms, please check my website, www. artofpracticemanagement.com, to ob- tain a copy. Again, thorough questioning of all new and established patients is an essential component to getting the full picture of your patients’ health. What is discovered from these ques- tions can be a strong determining factor in how each patient is handled. Patient questioning should always be followed by dental exams, X-rays, blood pressure checks and clinical observations. For those patients who may have a systemic disorder, your practice should become proactive by referring the patient back to his or her primary care provider. However, because dentistry has evolved over the last decade, there are more ways that the dental practice can help make these determinations. With the frequency of patients’ visits and the availability of numerous cutting edge diagnostic tools, we have the unique op- portunity to administer different types of disease testing that, in the past, were performed only by medical practices. Medical testing options If you are unfamiliar with the types of medical testing that are available for dental practices to perform, then the fol- lowing information can make a big dif- ference in the quality of your practice’s treatment, and it may help to make a significant change in how you perceive your career. First of all, periodontal diseases and caries are bacterial infections, but the majority of dental practices diagnose these conditions through the use of peri- odontal probes and explorers. Have you considered that medical practices would never begin treatment without deter- mining if they are treating bacteria or a virus? In dentistry, we need to differen- tiate between aspirin sensitivity, blood dyscrasias, other diseases, fungus, yeast or a cyst; so bacteriologic tests should be performed.2 Microscopic tests, DNA tests, or bacteriologic tests should be performed if periodontal infections are apparent. Tests that can be performed in a dental practice: •HgA1c for blood sugar •C-reactive protein (CRP) for inflam- mation •BANA for bacterial pathogens or their byproducts •DNA for the presence of specific pathogens or for patient susceptibil- ity to periodontal disease •TOPAS for inflammatory markers •Oral HPV testing •Diabetes testing with a glucometer — finger stick or blood sample taken from a periodontal pocket •Oral cancer screening (e.g. ViziLite) •HIV testing •Screening for cardiovascular disease (e.g. HeartScore System) •Saliva biomarker test — measures three specific biomarkers that play a role in cancer development in the oral cavity As you can see, these tests cover many possible systemic conditions. Your practice will have to determine which staff members are allowed to ad- minister these tests, because your state makes regulations controlling this. Hy- gienists may be allowed and, if so, this may make a difference in your career. Even if hygienists are not allowed per your state’s regulations, your encourage- ment in the practice to add these tests to the practice’s procedure mix will be in- valuable to the practice. In addition, hy- gienists need to realize the importance of their observations and questioning of the patients in helping to move these pa- tients to better overall health. This puts a new slant on the same-old, same-old. The Power of cross coding There is, however, another area in which hygienists can make a significant differ- ence in their practices. Dental-medical cross coding is a cutting-edge insurance system whereby dental practices can file a patient’s medically necessary dental D2 Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Chief OPerating OffiCer Eric Seid e.seid@dental-tribune.com grOuP editOr & designer Robin Goodman r.goodman@dental-tribune.com editOr in Chief dental tribune Dr. David L. Hoexter feedback@dental-tribune.com editOr in Chief hygiene tribune Patricia Walsh, RDH feedback@dental-tribune.com managing editOr Robert Selleck r.selleck@dental-tribune.com managing editOr shOw dailies Kristine Colker k.colker@dental-tribune.com managing editOr Fred Michmershuizen f.michmershuizen@dental-tribune.com managing editOr Sierra Rendon s.rendon@dental-tribune.com PrOduCt/aCCOunt manager Mara Zimmerman m.zimmerman@dental-tribune.com PrOduCt/aCCOunt manager Charles Serra c.serra@dental-tribune.com marketing direCtOr Anna Kataoka-Wlodarczyk a.wlodarczyk@dental-tribune.com eduCatiOn direCtOr Christiane Ferret c.ferret@dtstudyclub.com aCCOunting COOrdinatOr Nirmala Singh n.singh@dental-tribune.com Tribune America, LLC 116 West 23rd Street, Suite 500 New York, NY 10011 Phone (212) 244-7181 Published by Tribune America © 2012 Tribune America, LLC All rights reserved. Tribune America strives to maintain the utmost ac- curacy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Managing Editor Robert Selleck at r.selleck@dental-tribune.com. Tribune America cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume respon- sibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Tribune America. editOrial bOard Dr. Joel Berg Dr. L. Stephen Buchanan Dr. Arnaldo Castellucci Dr. Gorden Christensen Dr. Rella Christensen Dr. William Dickerson Hugh Doherty Dr. James Doundoulakis Dr. David Garber Dr. Fay Goldstep Dr. Howard Glazer Dr. Harold Heymann Dr. Karl Leinfelder Dr. Roger Levin Dr. Carl E. Misch Dr. Dan Nathanson Dr. Chester Redhead Dr. Irwin Smigel Dr. Jon Suzuki Dr. Dennis Tartakow Dr. Dan Ward Tell us what you think! Do you have general comments or criticism you would like to share? Is there a particular topic you would like to see articles about in Hygiene Tribune? Let us know by e-mailing feedback@dental-tribune.com. We look forward to hearing from you! If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental- tribune.com and be sure to include which publication you are referring to. Also, please note that subscription changes can take up to six weeks to process. ◊ OVERALL, page D1 COMMENTARY Hygiene Tribune U.S. Edition | March 2012 The NOMAD handheld X-ray system. Photos/Provided by Aribex As a recent article on [www.dental-tribune. com] points out, there are some safety issues with hand-held X-ray units made in China and Korea, as well as else- where outside of the United States. There are two sources of radiation from an X- ray system — leakage radiation from the X-ray tube and scattered radiation from the patient. The leakage radiation is minimized by placing highly absorbing material, such as lead, around the X-ray tube. The major issue with the hand-held X-ray units is the scattered radiation, that is X-rays that are scattered from the patient towards the operator. In fact, about 20 to 30 percent of the X-rays are scattered from the patient toward the person holding the device. The X-ray units from outside the United States, which are under FDA scrutiny, do not provide any protection from X-rays scattered from the patient. These sys- tems look like a large camera that you hold with both hands. There is no shielding provided by these hand-held systems; that is, the user’s hands are exposed to all of the X-rays scattered from the pa- tient. Consequently, the user’s hands are going to receive a radiation dose that will probably exceed the radiation- protection limits for skin and extremities. Therefore, these units should not be hand-held. We evaluated one hand- held X-ray unit manufac- tured in the United States (Nomad, Aribex Inc.) and compared staff doses with those for the same staff using conventional wall-mounted systems prior to acquiring the hand-held systems (Gray et al. 2012). This hand-held system uses a proprietary shielding material around the X-ray tube, resulting in leakage ra- diation levels that are virtually immea- surable. In addition, it has an integral leaded-acrylic shield that protects the user from radiation scattered from the patient. The results of our study indicated that the users of the hand-held X-ray system received lower radiation doses than they did when they were using conventional Commentary: Not all hand-held X-ray systems are created equal wall-mounted X-ray systems. Buyers should be aware that not all hand-held X-ray systems are created equal and not all of those being sold on the web have been reviewed by the FDA. Hand-held X-ray units should have sufficient shielding to minimize leak- age radiation from the X-ray tube and an integral shield to protect from radiation scattered from the patient. By Joel Gray, phD Joel Gray, PhD ” See OVERALL, page D3 Hinman BOOTH nO. 923 ‘Dental-medical cross coding is a cutting-edge insurance system whereby dental practices can file a patient’s medically necessary dental procedures with their medical plans.’