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Oral diseases: a global public health challenge

The Lancet Published:July 20, 2019DOI:

 Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases globally are dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers in a Series on oral health, we describe the scope of the global oral disease epidemic, its origins in terms of social and commercial determinants, and its costs in terms of population wellbeing and societal impact. Although oral diseases are largely preventable, they persist with high prevalence, reflecting widespread social and economic inequalities and inadequate funding for prevention and treatment, particularly in low-income and middle-income countries (LMICs). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Children living in poverty, socially marginalised groups, and older people are the most affected by oral diseases, and have poor access to dental care. In many LMICs, oral diseases remain largely untreated because the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and can include unremitting pain, sepsis, reduced quality of life, lost school days, disruption to family life, and decreased work productivity. The costs of treating oral diseases impose large economic burdens to families and health-care systems. Oral diseases are undoubtedly a global public health problem, with particular concern over their rising prevalence in many LMICs linked to wider social, economic, and commercial changes. By describing the extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgent need to address oral diseases among other NCDs as a global health priority.

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A clinical study on the 6-year outcomes of immediately loaded three implants for completely edentulous mandibles: “the all-on-3 concept”


pp 1–10 | Cite as

Original Article

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The objective of the current study was to demonstrate the 6-year clinical and radiological treatment outcomes of the technique performed by immediately loading of three implants (single straight in the mid-line and two tilted distal implants) for the management of total edentulous mandibles and introduce a simple decision matrix for selection of the most appropriate protocol in cases with insufficient length of the interforaminal area. Re-assessments were performed over a total observation period of 6 years after surgery via measurement of bone resorption around implants, bleeding on probing, plaque accumulation, periodontal probing depth, bite force measurements and oral health impact profile. A total of 29 patients (45% women and 55% men) with a mean age of 65 ± 6 years enrolled in the study. 14 patients received an acryl-based bridge as definitive prosthetic restoration and 15 patients received a ceramic-based restoration. Both during the immediate loading phase and during the 6-year follow-up, there was no implantation loss. Regardless of the implant position, all implants showed continuous bone loss over the observation time. The bone loss around dental implants during observation period was only maximum 1.0 ± 1 mm and it remained well within the limits for ‘success’ according to the 2007 Pisa consensus (< 2 mm). The plaque index showed no significant fluctuations between the implant positions and the individual examination times. The approach described herein might help the surgeon by avoiding unnecessary loss of bone strength, selecting implant sites, and establishing the biomechanical advantage of increased A–P spread for immediate function.
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Risk factors for recurrence of periodontal disease in patients in maintenance care in a private practice.

J Clin Periodontol. 2019 Jul 4. doi: 10.1111/jcpe.13165.



To assess periodontal and dental conditions in individuals in maintenance care after periodontal therapy in private practice, and identify risk factors for recurrence of disease and tooth loss.


100 patients attending a routine recall visit were included. All had been treated for periodontal disease and were in maintenance since ≥2 years.


Examinations took place 18.0 (±8.71) years after the start of periodontal therapy. 40.1±22.5 recall visits were registered during this time. 91% of the participants had an initial diagnosis of chronic, 9% of aggressive periodontitis. The average participant was 46 years old and had 26 teeth. 283 of 2549 initially present teeth were lost, half of them being molars. Periodontal and endo-periodontal complications accounted for only 16 lost teeth. The prevalence of all probing depth (PD) categories decreased significantly. The longer the time, the more frequent the recall visits, and the more was spent during the maintenance phase the greater was the reduction. Multivariate analysis rendered BMI and smoking as factors influencing number of sites with PPD ≥4 mm and BOP.


Tooth loss and periodontal tissue damage can be contained over prolonged periods if periodontal disease is treated and patients attend regular maintenance care.

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Are You Curing Your Dental Materials? checkUp Lets You Know.

Are you curing your composites?
Curing composites does not mean turning on the curing light and assuming since the top layer is hard everything has been done properly.  There are many importation aspects to properly curing all of the materials that we use in our daily workflows. Since about half of our procedures require a curing light. From bonding agents, composites and core materials all of these require proper cure times based on the power output of the lights along with excellent technique.  Incomplete curing causes a host of problems for both the patient and dentist.

There is a new product on the market that is more then just a radiometer and its from a company called Blue Light Analytics.  They have a device called checkUp. Using Bluetooth the device connects to an app on your smartphone. It looks like a small hockey puck and not only measures the power output of your curing light but uses artificial intelligence to query its database of materials to guide you on the proper curing times for all your materials.

Here are some screenshots of my recent use of checkUP. One of the interesting things I have found out is my brand name barriers actually reduce my output by approximately 100mw/cm2.

For a limited time you can purchase the checkUp device and service by clicking here for the July special of 50% off

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Comprehensive assessment of dental behaviour and oral status in patients with tongue piercing—results of a cross-sectional study

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Aim of this cross-sectional case-control study was the comprehensive examination of oral health, oral behaviour and oral health-related quality of life of patients with tongue piercing. Furthermore, different piercing related factors and the presence of habits should be considered regarding their potential association to piercing-related complications.

Material and methods

Participants with tongue piercing (n = 50) and a matched control (n = 50) were included. Dental examination included decayed-, missing- and filled-teeth-index (DMF-T) and the presence of non-carious tooth defects. Periodontal examination contained of periodontal probing depth (PPD), bleeding on probing (BOP) and recession. Piercing-related factors, oral behaviour as well as oral health-related quality of life [German short form of oral health impact profile (OHIP G14)] were assessed based on questionnaires. Statistics: Man-Whitney U test, chi-square and Fisher’s exact test (significance level p < 0.05).


Participants with tongue piercing suffered from worse DMF-T, PPD, BOP and recession (pi < 0.01). Higher prevalence of enamel cracks and trough-shaped abrasions were found in piercing-group (pi < 0.01). Additionally, participants with tongue piercing showed worse oral behaviour, insufficient cleaning of piercing and in majority of cases (80%) calculus formation at piercing surface as well as comparable OHIP-G14 to control (p = 0.39). While piercing design was associated to both, recession and non-carious tooth defects (pi < 0.05), only infractures of enamel were associated to the presence habits (p = 0.04).


Patients with tongue piercing show insufficient dental and periodontal health as well as reduced oral behaviour. Thereby, piercing design and wearing period is associated to recessions and non-carious tooth defects.

Clinical relevance

Increased attention of patients wearing tongue piercing in dental practice is necessary.
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Case Report Mandibular incisor extraction: A treatment alternative for large maxillary midline diastema

International OrthodonticsInternational Orthodontics

Available online 3 July 2019


Maxillary midline diastema is a common aesthetic concern of dental patients. Various treatment modalities have been employed to close diastemas. This case report describes an unusual orthodontic treatment approach for a 25-year-old African American female patient with a large maxillary midline diastema of 5 mm, bialveolar dental protrusion and unilateral Class III malocclusion. The treatment included one mandibular incisor extraction, followed by retraction of the incisors. At the end of the 16-month active treatment period, favourable aesthetic and occlusal outcomes were attained. Closure of midline diastema, good overjet and overbite with Class I molar relationships were achieved.

Clinical significance

Fixed orthodontic treatment with single mandibular incisor extraction can be an effective treatment choice for a large maxillary midline diastema. With careful selection of the case and treatment planning, successful results can be obtained.
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