The Flint Water Crisis & What The Dental Industry Can Do To Safeguard Public Health

A Step Forward in Throat Cancer Research

Possible Cure for HPV+ Throat Cancer

New research shows that HPV+ OPC patients can be cured, even after the disease has spread to other organs

Certain types of human papillomavirus (HPV) can lead to persistent infections that may progress to cancer if left untreated. These cancers, including cancer of the oropharynx (base of the tongue and tonsils), can take years or even decades to develop after initial diagnosis. Such cancers are typically considered to be incurable and the goal of treatment is usually limited to symptom control.

Now, for the first time, researchers have found evidence to suggest that patients with cancer of the throat caused by the human papillomavirus (HPV+) have a better prognosis than those who are negative for the virus (HPV-).

Dr. Sophie Huang, Assistant Professor of Radiation Oncology at the University of Toronto, has discovered that the oropharynx can actually be cured even after the disease has already spread to other critical organs in the body, such as the lungs.¹ She conducted what is now the largest study to date with over 900 patients to investigate survival predictors for metastatic HPV+ oropharyngeal cancer (OPC) and HPV- OPC patients, or patients who have tumors appearing in an organ not directly related to the primary cancer site.¹ In fact, patients with OPC and oligometastasis (involving five or fewer lesions in one distant organ) can live for more than 2 years after intensive treatment without further disease growth.¹

“Our research […] has shown that cure is a realistic goal in those patients with oligometastasis.”

Sophie Huang, MSc, Assistant Professor, Department of Radiation Oncology, University of Toronto

Three main factors allow for a survival advantage for HPV+ OPC patients:

  1. This type of cancer is more sensitive to radiotherapy and chemotherapy
  2. Patients were generally younger and diagnosed 10 years earlier than average
  3. Patients had fewer health problems, including those associated with smoking.

This is an important step forward in head and neck cancer research, a cancer type with historically low awareness despite being the sixth most common type of cancer worldwide.


¹ European Society for Radiotherapy and Oncology (ESTRO). (2015, February 12). “New research shows possibility of cure for HPV positive throat cancer patients.” ScienceDaily.


Section 179 in 2014

Update on the 2014 Section 179 Tax Deduction

You still have thirty days to make the most of $25K

Section 179 of the IRS tax code has gotten a lot of heat for its diminished deduction limit in 2014. Compared to last year’s deduction limit of $500,000 for equipment purchases, the 2014 limit has been reduced to $25,000. Despite the ADA’s efforts in urging Congress to extend the Section 179 tax provision to 2013 levels, there hasn’t been any word on whether an extension will be granted.

The silver lining: although $25,000 isn’t as desirable as $500,000, Section 179 provides some real relief to dental practice owners purchasing small equipment in 2014. Section 179 can change each year without notice, so it’s beneficial to take advantage of any deduction while it’s still available.

Up to $25,000 in dental equipment can be written off in 2014


Most tangible goods qualify for the Section 179 Deduction. For basic guidelines on what equipment is covered under the Section 179 tax code, refer to this list of qualifying equipment. Note: To qualify for the Section 179 Deduction, the equipment and/or software purchased or financed must be placed into service between January 1, 2014 and December 31, 2014.

All new and used equipment is eligible for deduction up to $25,000 for 2014. All companies that lease, finance or purchase equipment with a total value of less than $200,000 still qualify for the Section 179 deduction. Expenses over that maximum amount begin to decrease on a dollar-for-dollar deduction scale, effectively gearing this tax code toward small and medium-sized businesses.


While Section 179 doesn’t increase the total amount you can deduct in a single year, it allows you to benefit from the deduction all at once. In other words, rather than having to deduct an asset’s value over the course of several years, Section 179 allows businesses to get the entire depreciation deduction in a single year, a practice known as first-year expensing.

According to regular depreciation rules, if you were to purchase new high-speed handpieces for each of your operatories, you’d be obligated to deduct a portion of each handpiece’s cost over multiple years. For the next five years, you’d only be able to deduct a fraction of the overall expense. With the Section 179 tax code, though, you are allowed to immediately deduct the entire expense of the handpieces in a single year instead of having to track their depreciation over time.

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Check out an example of Section 179 at work:



Sharpen Tools for Swifter Turnover

Sharper Tools Mean Greater Efficiency

Instruments are essential to any dental procedure, and the sharper they are, the better. Proper sharpening techniques not only make for longer-lasting instruments, they enable quicker patient turnover due to more efficient hygiene procedures. Do your practices measure up?


For your 6-month prophylaxis appointments, it’s recommended you sharpen your instruments at least once a week. For your scaling and root planing procedures, sharpen your instruments before each procedure. Manual stones are easier because they are portable and can be used anywhere in the office. Automatic sharpeners require a power source, which limits when and where you can use them.

Purchasing Frequency

The average office should order new instruments at least once a year. A good rule of thumb is to have enough procedure setups for a half-day’s patients. This number can be determined by averaging the number of procedures per day over several weeks. If your practice doesn’t have a good supply of instruments, invest in more setups to improve your efficiency.

Instrument Knowledge

The most unbiased and universal way to check if an instrument is sharp would be to use a test stick. Each hygienist uses different pressures when scaling teeth; thus, basing instrument sharpness on pressure applied isn’t an objective test.


PureLife carries every instrument needed for your hygiene procedures. The Montana Jack scaler and Wingrove Titanium Implant Instruments are unique additions to any dental office. The ultra-light Montana Jack is a hybrid universal scaler that can be used for the entire mouth. The Wingrove Titanium Implant Instruments boast solid medical-grade titanium that won’t scratch implants.

Handling Pediatric Patients

Pediatric Patients

Even super-heroes should be handled with kid gloves

By now, you may have heard about the potential impacts of the Affordable Care Act (ACA) on dentistry. One interesting likelihood: an influx of pediatric patients, as the ACA provides for dental coverage for children under 19. According to the American Dental Association (ADA), approximately 8.7 million children could gain extensive dental coverage by 2018. This means that more general dentists will have the opportunity to see younger patients. However, there are several things to consider when treating this population.

Chemical Sensitivities

Children aren’t just little adults. Their bodies are still developing, so chemicals that might not have much of an impact on an adult can have a larger impact on a child. A case in point: BPA.

Bisphenol A (BPA), a chemical compound found in everyday plastic products, can also be found in many dental composites and sealants. Unfortunately, BPA acts as an endocrine disrupter, and studies have linked it to a plethora of health maladies in children, including heart and kidney disease, emotional behavioral problems, and even an increased risk of obesity in teenaged girls.

In addition to these generalized health issues, BPA has also become a dental concern: research from France has suggested that BPA exposure in children can adversely affect cells that produce tooth enamel, making it fragile or brittle. This Molar Incisor Hypomineralisation (MIH), which occurs selectively in permanent incisors and first molars, affects about 18% of children between the ages of 6 and 8. Children with MIH are highly prone to dental caries and are very susceptible to tooth sensitivity and pain. Importantly, the age at which children develop their first molars and permanent incisors is the age at which studies show that humans are most sensitive to BPA.

The Asthma Link

Most recently, asthma – one of the most common childhood diseases – has been linked to BPA exposure, according to a recent study at the Columbia Center for Children’s Environment Health at the Mailman School of Public Health (Donohue, 2013). This is important to dental healthcare professionals because another study has linked asthma to an increased risk of dental caries (Alkali, 2013). Asthma medications were shown to reduce the salivary flow rate and buffering capacity in the mouth, leading to a potential for increased caries and gingivitis. Asthmatic children also had higher levels of Strep mutans and Lactobacillus bacteria, compared to healthy children.

Alternatives for Improved Health

Since dental caries is the most prevalent disease in children, it’s important to be on the lookout for increased caries risk factors, like asthma. Fortunately, dental healthcare providers have a number of tools available to help reduce the prevalence of caries in their pediatric patients, without exposing them to additional doses of BPA.

For example, for patients with increased caries risk factors, dentists might want to consider a chlorhexidine varnish. A relatively new product, chlorhexidine varnish addresses the undesirable side effects of chlorhexidine rinses and gels, while still reducing the presence of Strep mutans (Sijjan, 2013).

BPA-free versions of many products are also available. The Venus Pearl and Venus Diamond lines of composites from Heraeus Kulzer are not only BPA-free, but highly durable and well-suited for both anterior and posterior restorations.

Manufacturer Pulpdent produces the BPA-free ACTIVA and Embrace product lines, the majority of which are especially well-suited for pediatric patients as they are hydrophilic (i.e., they work well in a moist environment). These products include the innovative ACTIVA BioACTIVE Restorative and ACTIVA BioACTIVE Base/Liner, as well as the Embrace Wetbond Pit & Fissure Sealant and Embrace Wetbond Resin Cement.

The Triclosan Controversy

What’s the Trouble with Triclosan?

Antibacterial agent comes under fire for potential health risks

Colgate Total has been in the news lately, thanks to one of its active ingredients – triclosan. The antibacterial chemical has come under increased scrutiny as new studies have raised questions about its safety. These studies show that triclosan may be influencing cancer cell growth and disrupting the way hormones work in animals.1 Whether these undesirable side effects are present in humans is harder to determine, but it doesn’t bode well for the chemical.

So why include a questionable chemical? Total’s patented formula has proved effective in reducing the bacteria that cause plaque and gingivitis, which can lead to periodontal disease.

However, triclosan’s use in other products hasn’t been proven to be beneficial. Triclosan can be found in many different types of products – everything from cosmetics to clothing to rugs. Its presence in some of the products that dental healthcare professionals use every day for infection control purposes might be cause for concern.

For example, triclosan is a common ingredient in antibacterial hand soaps, even though it has not been proven to be more effective at reducing illness than washing hands properly with regular soap and water. It’s this fact that has the FDA re-examining the safety and efficacy of including triclosan in soap and body washes, outside of hospital settings.

According to FDA microbiologist Colleen Rogers, Ph.D., “New data suggest that the risks associated with long-term, daily use of antibacterial soaps may outweigh the benefits.” In addition to the cancer and hormonal effects, triclosan is also suspected of contributing to bacterial resistance of antibiotics – a problem with broad-reaching implications.

Fortunately, it’s easy to move away from hand soaps containing triclosan, while taking the opportunity to emphasize the importance of following a proper hand-washing protocol with your team. Hand sanitizers, which also might contain triclosan, are available in triclosan-free versions with alcohol as the active ingredient – look for at least 60% alcohol make sure to use enough to wet hands for at least 15 seconds.

1 Tiffany Kari, Colgate Total Ingredient Linked to Hormones, Cancer Spotlights FDA Process, (, August 11, 2014

X-Ray Radiation Protection

Radiation Protection

Easy ways to avoid harmful x-ray exposure

Dental x-rays are critical to evaluating and diagnosing many oral diseases and conditions. Although radiation exposure from x-rays is low, the effects can accumulate from multiple sources over time. Limiting radiation exposure can be achieved through these simple techniques:


Obtaining and reviewing previous full-mouth series or panoramic x-rays can eliminate the need to take new radiographs. For example, patients with stable periodontal health and a low caries rate may be able to increase the time between bitewings from annually to every 18 to 24 months years (ADA, 2012). If new radiographs are necessary, radiation exposure can be decreased through the use of higher film speeds, shielding, and collimation.

HIGHER FILM SPEEDS: Using the fastest film available significantly reduces radiation exposure. Currently, intraoral X-ray film is available in three speeds: D, E, and F. E-speed film is almost twice as fast as D-speed film—and about 50 times faster than traditional x-ray film. F-speed film requires about 25% less exposure than E-speed film and 60% less exposure than D-speed film. Multiple studies have confirmed that F-speed film has the same useful density range, latitude, contrast, and image quality as D- and E-speed films, and it can be used in routine intraoral radiographic examination without sacrificing diagnostic information (ADA, 2012).

SHIELDING: The use of aprons and thyroid collars shields the gonads and thyroid gland from radiation exposure, which is particularly important among vulnerable populations, such as children and pregnant women. The ADA recommends that every patient should be covered with an apron. When taking routine bitewing and periapical radiographs, a thyroid collar should be used. Panoramic imaging is an exception to the rule; a thyroid collar can obscure large areas of the target zone (ADA, 2012).

COLLIMATION: A collimator is a metallic barrier with an opening in the middle that is used to reduce the size of the x-ray beam, and, thus, the exposure area. Dental x-ray beams are usually collimated to a circle 2¾” in diameter. When an x-ray beam is directed at a patient, the hard and soft tissue absorbs about 90% of the photons, while approximately 10% passes through the patient and reaches the film (ADA, 2012).


Although dental professionals receive less exposure to ionizing radiation than do other occupationally-exposed healthcare workers, operator protection measures are essential to minimize exposure. Protective measures include the use of barrier shielding, occupational radiation exposure limits, and personal dosimeters.

SHIELDING: When possible, operators of radiographic equipment should use barrier protection, and barriers should ideally contain a leaded glass window to enable the operator to view the patient during exposure. When shielding is not possible, the operator should stand at least two meters from the tube head and out of the path of the primary beam.

The maximum permissible annual dose of ionizing radiation for health care workers is 50 millisieverts (mSv) and the maximum permissible lifetime dose is 10 mSv multiplied by a person’s age in years. Personal dosimeters must be used by workers who may receive an annual dose greater than 1 mSv to monitor their exposure levels. Pregnant dental personnel operating x-ray equipment must also use personal dosimeters, regardless of anticipated exposure levels (ADA, 2012).

PureLife now offers personal dosimeters that measure the amount of high energy ionizing radiation a person has been exposed to. The PureLife Radiation Detection Badge is a small, reliable badge designed for superior accuracy, easy handling and cleanliness.