OJ Worse for Teeth than Whitening, Says Eastman Institute for Oral Health Researchers

With the increasing popularity of whitening one’s teeth, researchers at the Eastman Institute for Oral Health, part of the University of Rochester Medical Center, set out to learn if there are negative effects on the tooth from using whitening products.

Eastman Institute’s YanFang Ren, DDS, PhD, and his team determined that the effects of 6 percent hydrogen peroxide, the common ingredient in professional and over-the-counter whitening products, are insignificant compared to acidic fruit juices. Orange juice markedly decreased hardness and increased roughness of tooth enamel.

Unlike ever before, researchers were able to see extensive surface detail thanks to a new focus-variation vertical scanning microscope. “The acid is so strong that the tooth is literally washed away,” said Ren, whose findings were recently published in Journal of Dentistry. “The orange juice decreased enamel hardness by 84 percent.”  No significant change in hardness or surface enamel was found from whitening.

Weakened and eroded enamel may speed up the wear of the tooth and increase the risk for tooth decay to quickly develop and spread. “Most soft drinks, including sodas and fruit juices, are acidic in nature,” Ren said. “Our studies demonstrated that the orange juice, as an example, can potentially cause significant erosion of teeth.”

It’s long been known that juice and sodas have high acid content, and can negatively affect enamel hardness. “There are also some studies that showed whitening can affect the hardness of dental enamel, but until now, nobody had compared the two,” Ren explained. “This study allowed us to understand the effect of whitening on enamel relative to the effect of a daily dietary activity, such as drinking juices.

“It’s potentially a very serious problem for people who drink sodas and fruit juices daily,” said Ren, who added that dental researchers nationwide are increasingly studying tooth erosion, and are investing significant resources into possible preventions and treatments. “We do not yet have an effective tool to avert the erosive effects, although there are early indications that higher levels of fluoride may help slow down the erosion.”

A Texas-based company, Beyond Dental and Health, sponsored the trial in part by providing the 6 percent hydrogen peroxide.

In the meantime, Ren advises that consumers be aware of the acidic nature of beverages, including sodas, fruit juices, sports and energy drinks. The longer teeth are in contact with the acidic drinks, the more severe the erosion will be. People who sip their drinks slowly over 20 minutes are more likely to have tooth erosion than those who finish a drink quickly. It’s also very important to keep good oral hygiene practices, Ren added, by brushing twice daily with fluoride toothpaste, and see a dentist for a fluoride treatment at least once a year if you are at risk.

Eastman Institute for Oral Health is a world leader in research and post-doctoral education in general and pediatric dentistry, orthodontics, periodontics, prosthodontics, and oral surgery. Patients are seen at many sites throughout the Rochester community.

URMC ANNOUNCES NEW DENTAL INSTITUTE

More Services for Rochester Residents Coming Soon

The University of Rochester Medical Center today announced the Eastman Institute for Oral Health, a division within the Medical Center and now a fully integrated dental enterprise, representing $8.1 million in research funding and 500 faculty, residents and staff. The new Institute brings together all its dental academic units: Eastman Dental Center, the School of Medicine and Dentistry’s Department of Dentistry and the Center for Oral Biology.

To address Rochester’s growing need, the Eastman Institute for Oral Health has begun the following renovations to improve clinical services for the community:

• Adding treatment rooms to Eastman Dental Downtown in Sibley Building – ready by July.
• New Urgent Care Center opening in January at its Elmwood Avenue site – to treat 60 patients a day.
• Adding treatment rooms in the General Dentistry and Orthodontic clinics, renovations to the lobby and Periodontics/Prosthodontics area
• Implant and restorative work

In addition, under the new structure, basic science and clinical researchers will work more closely together to translate scientific discoveries for patients’ benefit, such as improving oral health care in children.

Cyril Meyerowitz, D.D.S, M.S., who has served as director of Eastman Dental Center for the last 10 years, has been appointed director of the new Institute. “By creating one dental enterprise university-wide, we will, for the first time, be able to truly realize our full potential,” he said.

“The organizational changes are designed to put us in an even better position to enhance education and research initiatives in dentistry,” said Mark B. Taubman, M.D., acting CEO for the Medical Center. Jack Caton, D.D.S., M.S., Periodontics chair and program director will serve as EIOH associate director for Education, while Robert Quivey, Ph.D., director of Center for Oral Biology, will serve as EIOH associate director for Research.

Eastman Institute for Oral Health is a world leader in research and post doctoral education in general and pediatric dentistry, orthodontics, periodontics, prosthodontics, and oral surgery. Patients are seen at sites throughout the community: Elmwood Ave., Eastman Dental Downtown, School #17, Hillside Children’s Center, Monroe Community Hospital, SMILEmobiles, Strong Memorial Hospital and Clinton Crossings.

Specialty Dental Services to URMC Continue During General Dentistry Clinic Transition

Expansion and relocation of Strong Memorial Hospital’s General Dentistry Clinic will improve services for patients while continuing to meet the specialized dental care needs of the URMC community.

The SMH Dentistry Clinic, currently located on the fourth floor of the Ambulatory Care Facility (AC4), will focus on more complex cases and expansion of oral surgery services. At the same time, Eastman Dental Center’s (EDC) General Dentistry’s Downtown Health Center location is expanding with updated technology in a spacious environment to accommodate and be more easily accessible to a majority of the SMH General Dentistry patients.

“We remain committed to serving the Medical Center community by providing for the needs of patients at Strong, and responding as we always have to requests for consults from the many departments with whom we interact,” said Cyril Meyerowitz, professor and chair of Dentistry and director of Eastman Dental Center. “While we transition the SMH General Dentistry Clinic to its expanded location, we want to be clear that these changes will not detract from our services to the Medical Center. For our internal customers, the many departments with whom we interact, it will be business as usual.”

Changes impact SMH General Dentistry Clinic patients only, as the clinic space on AC4 is restructured to accommodate more oral surgery and specialty services. Also under way is the updating and expansion of EDC’s Downtown Health Center location, in the Sibley Building at 228 East Main St.

“We are upgrading our downtown location with the latest technology and spacious facilities for the care and comfort of our general dentistry patients,” said Todd Thierer, D.D.S., M.P.H, director of SMH Ambulatory Dental and Oral and Maxillofacial Services. “This site is more easily accessible, being downtown and on major bus routes, and we expect will be more convenient for many of our patients.” The expansion should be completed by mid July.

SMH General Dentistry patients have three options for their care during this transition, as patient appointments are no longer available at the AC4 location.

1. Those who wish to continue coming to the URMC campus for their general dental care may make appointments at the Eastman Dental Center’s General Dentistry Clinic by calling 275-5051.
2. General dental care appointments are available at the EDC Orchard Street Community Health Center at School #17, 158 Orchard St., Rochester, by calling 436-8123.
3. EDC Downtown Health Center, 228 East Main St., Rochester, has a limited number of general care appointments available while renovations are under way. For appointments, call 263-6599.

URMC departments in need of consultative or specialty services may continue to access those services by requesting consults through the CIS system.

Questions regarding these changes may be emailed to Meyerowitz at cyril_meyerowitz@urmc.rochester.edu or Thierer at todd_thierer@urmc.rochester.edu.

Eastman Dental’s John Borrelli Receives Meliora Award

John Borrelli.

Time. Energy. Heart. That’s what John Borrelli brings every day to his job as director of finance and administration at the Eastman Dental Center. They are themes that appear repeatedly in comments from colleagues who nominated Borrelli for the University’s Meliora Award.

With the University since 1987, he oversees about 185 staff members and works closely with several departments as well as state representatives and community leaders.

Borrelli is credited with leading a Medicaid rate appeal, which, to date, has resulted in $372,000 in payments to the dental center. Eastman Dental Center provides care to two out of every three Medicaid patients in the greater Rochester area. The rate appeal and increase helps the center continue its commitment to quality care. He also played an integral role in the successful bid for a Health Care Efficiency and Affordability Law (HEAL) state grant, in which the center was awarded $3,925,000 to expand oral health care services in Rochester’s underserved communities.

“The knowledge and fortitude that John has exhibited during the (Medicaid rate appeal) is symptomatic of his invaluable work ethic,” writes Michael Goonan, vice president and CFO of the Medical Center, in his nomination letter.

Cyril Meyerowitz, director of the Eastman Dental Center, says Borrelli always strives for excellence.

“He undoubtedly exemplifies the University’s motto, “Ever Better,” and is committed to advancing Eastman Dental Center well into the future,” Meyerowitz writes in his nomination.

Borrelli says he’s honored to receive the Meliora Award and says it reflects the hard work and dedication of the dental center team.

“The favorite part of my job is working with fantastic employees who give their best every day,” he says. “Without them I could not perform my role.”
http://www.rochester.edu/working/hr/awards/meliora/2009.html

American Association of Dental Research Call for Abstracts

The Annual Meeting of the Rochester Section of the American Association for Dental Research (AADR) will be held on Tuesday, June 9, 2009 at the Forbes Lounge and the Ryan Case Method Room.
All researchers from the Rochester area are cordially invited to submit an abstract for either the competition or the non-competition category of the scientific program. AADR membership is not required.

Abstract Form

Abstract Instructions

Deadline for abstracts: May 26, 2009

Competition Category

The Basil G. Bibby Award will be given for outstanding scientific merit among presentations by non-degree candidates (i.e., technical staff, students, residents and those not currently enrolled in an M.S./Ph.D. program).

The Michael G. Buonocore Award will be given for outstanding scientific merit among presentations by candidates currently enrolled in an M.S./Ph.D. program.

The William H. Bowen Award will be given for outstanding scientific merit among presentations by degree candidates (PhD and postdoctoral levels).

Abstracts may be presented in either poster or oral format according to AADR/IADR guidelines. Bibby, Buonocore and Bowen Award winners will be selected by a panel of judges on the basis of outstanding scientific merit through:

1. Relevance and originality of hypothesis
2. Clarity of presentation
3. Use of innovative experimental design, methods, or data presentation
4. Findings or results that contribute significantly to the advancement of knowledge in the field of interest. Previous award winners are not eligible to compete within the same category

Non-Competition Category

Abstracts of a basic science or clinical research project can be also submitted for a non-competitive oral or poster presentation. Members of the faculty are invited to participate.

All abstracts are to be submitted in accordance with AADR/IADR format using the attached form.
Abstracts must be received by 5:00 P.M. on May 26.
Abstracts may be submitted to Ms. Kathy Bohn, Eastman Dental Center, Box 683.

Scientists Discover Why Teeth Form in a Single Row

A system of opposing genetic forces determines why mammals develop a single row of teeth, while sharks sport several, according to a study published today in the journal Science. When completely understood, the genetic program described in the study may help guide efforts to re-grow missing teeth and prevent cleft palate, one of the most common birth defects.

Gene expression is the process by which information stored in genes is converted into proteins that make up the body’s structures and carry its messages. As the baby’s face takes shape in the womb, the development of teeth and palate are tightly controlled in space and time by gene expression. Related abnormalities result in the development of teeth outside of the normal row, missing teeth and cleft palate, and the new insights suggest ways to combat these malformations.

The current study adds an important detail to the understanding of the interplay between biochemicals that induce teeth formation, and others that restrict it, to result in the correct pattern. Specifically, researchers discovered that turning off a single gene in mice resulted in development of extra teeth, next to and inside of their first molars. While the study was in mice, past studies have shown that the involved biochemical players are active in humans as well.

“This finding was exciting because extra teeth developed from tissue that normally does not give rise to teeth,” said Rulang Jiang, Ph.D., associate professor of Biomedical Genetics in the Center for Oral Biology at the University of Rochester Medical Center, and corresponding author on the Science paper. “It takes the concerted actions of hundreds of genes to build a tooth, so it was amazing to find that deleting one gene caused the activation of a complete tooth developmental program outside of the normal tooth row in those mice. Finding out how the extra teeth developed will reveal how nature makes a tooth from scratch, which will guide tooth regeneration research.”

Why Extra Teeth Formed

When we lose our baby teeth, the permanent teeth grow in to replace them, but permanent teeth when lost are lost for good. U.S. adults aged 20 years and older are missing an average of four teeth due to gum disease, trauma or congenital defects. Tooth loss makes chewing difficult, causes speech problems, accelerates oral disease, and disfigures the face. Current treatments for missing teeth include dentures or dental implants, but each procedure comes with disadvantages. The idea of growing teeth to replace missing ones has captured the imaginations of scientists, with many labs investigating ways to regenerate teeth.

In the current study, Jiang and colleagues generated mice that lacked the oddskipped related-2 (Osr2) gene, which encodes one of many transcription factors that turn genes on or off. “Knocking out” (deleting) the Osr2 gene resulted in cleft palate, a birth defect where the two halves of the roof of the mouth fail to join up properly, leaving a gap. Secondly, and surprisingly, the Osr2 “knockout” mice developed teeth outside of the normal tooth row. Jiang decided to focus his research first on the effect of Osr2 on teeth patterning (vs. cleft palate) because much more was known at the time about teeth development pathways.

Although teeth usually do not become visible until after birth, their formation starts early in development. Teeth develop from the epithelium and mesenchyme, two key tissue layers within the mammalian embryo. The first sign of tooth development in mammals is the thickening of the epithelium along the jaw line to form a band of cells called the dental lamina. Because all teeth subsequently form from the dental lamina, the assumption was that some special quality of epithelial cells there made them “tooth competent.” Classical experiments, however, found that the developing tooth mesenchyme was capable of inducing tooth formation from epithelial tissues that normally would not participate in tooth development. Researchers confirmed that it was indeed the mesenchyme that carried tooth initiation signals later in development, but how those signals were restricted to the area beneath the tooth row was unknown.

Past studies in other labs had shown bone morphogenic protein 4 (BMP4) to be an important factor for the initiation of teeth, and that a protein called Msx1 amplifies the BMP4 tooth-generating signal. Jiang and colleagues suggested for the first time that some unknown factor was restricting the growth of teeth into one row by opposing the Bmp4 signal.

The current study provides the first solid proof that the precise space where mammals can develop teeth (the “tooth morphogenetic field”) is shaped and restricted by the effect of Osr2 on the expression of the Bmp4 gene within the mesenchymal cell layer. Jiang’s team has shown not only that removing the Osr2 gene results in extra teeth outside of the normal row, but also that Osr2 is expressed in increasing concentration in the jaw mesenchyme as you move from the cheek toward the tongue in the mouse embryo, the exact opposite of the BMP4 concentration gradient. Osr2 restricts Bmp4 expression to the tooth mesenchyme under the dental lamina, and in Osr2’s absence, Bmp4 gene expression expands into the jaw mesenchyme outside of the tooth row.

A second major finding of the study backs up another emerging theory which holds that careful regulation of competing pro- and anti-tooth initiation signals controls how mammalian teeth come one by one in sequence. As each tooth develops, something must prevent it from forming too close to the next or mammals would have no gaps between their teeth. When this mechanism occasionally falters, adjacent teeth come in fused together. Since evolution is not perfect, wisdom teeth (third molars) often come in too close to their predecessors, and must be pulled to make space.

Jiang and colleagues also engineered a group of mice with both the Osr2 and Msx1 genes removed. While mice without Msx1 failed to grow any teeth, mice lacking both Msx1 and Osr2 grew the first molars, but no additional teeth. Thus, without Osr2, enough BMP4 was expressed for the first molar teeth to grow, but without Msx1, the BMP4 signal was not amplified to the point where it could kick off the next tooth in the row. With these results, Jiang argues that BMP4 cooperates with other factors to create a temporary zone around each tooth where no other tooth can grow. When the tooth gets closer to maturity, Msx1 overwhelms decreasing levels of inhibitory factors to start the BMP4-driven development of the next tooth. Since the jaw is growing at the same time teeth are forming, it follows that each tooth must also receive signals that enough jaw has grown in for the next tooth to start forming atop it.

The implications of the current results may go beyond tooth development, researchers said. Thanks to the work of Jiang and others, some of the biochemical pathways involved in cleft lip/cleft palate development are now recognized, and may include BMP4, Msx1 and OSR2 as well as several others. In humans, Msx1 mutations have been linked with cleft lip/palate and with the failure to develop one or more teeth. In the next phase of the team’s work, researchers will look at what other factors may be regulated by Msx1 and Osr2 to begin pinpointing the genetic network that controls teeth patterning and palate development. Their goal is to manipulate stem cells to treat malformations and to develop prevention strategies for cleft palate (e.g. the inclusion of folic acid in prenatal vitamins prevents neural tube defects in some cases). Cleft lip/palate occurs one in 700 live births.

Along with Jiang, the work was led by Zunyi Zhang and Yu Lan within the Center for Oral Biology and Department of Biomedical Genetics at the Medical Center. Yang Chai collaborated on the effort from the Center for Craniofacial Molecular Biology at University of Southern California School of Dentistry in Los Angeles. The work was sponsored by the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health.

“Beyond medical applications, our results suggest that diversity in the number of tooth rows across species may be due to evolutionary changes in the control of the BMP4/Msx1 pathway,” Jiang said. “In mammals, Osr2 suppresses this pathway to restrict teeth within a single row.”

###

For more media inquiries, contact:
Greg Williams
(585) 273-1757
greg_williams@urmc.rochester.edu

Eastman Dental Offers Savings on Dental Implant Services

If you are missing teeth, and are considering dental implants, you may be able to save a significant amount of money and enjoy the convenience of staying right on campus. You may even discover if you qualify for one of many implant research studies currently being conducted.

People in need of dental implants can save 30 percent or more at Eastman Department of Dentistry/Eastman Dental Center, a part of the University of Rochester Medical Center. There are new techniques that make implants possible where in the past they could not be done. Recent developments in dentistry demonstrate that the use of shorter implants, bone grafting, and sinus augmentation procedures have made implants possible for a large number of people.

There are even techniques to support dentures in patients who do not have teeth or adequate ridges. Implants can be used to stabilize dentures in patients who have insufficient bone support for their dentures.

“It’s becoming more common to immediately place the crown or bridges with the implant, no longer needing several weeks for healing,” said Dr. Georgios Romanos, clinical professor in the Eastman Department of Dentistry.

“It becomes a quality of life issue when one’s ability to eat, smile and socialize becomes compromised,” said Dr. Cyril Meyerowitz, director, Eastman Dental Center. “As part of the URMC community, we’re available to help.”

After earning a dental degree, dentists may choose to begin practice, or continue their education in General Dentistry, Orthodontics, Oral Surgery, Pediatric Dentistry, Periodontology and Prosthodontics at a post-graduate institution, such as Eastman Department of Dentistry/Eastman Dental Center. Each year, the world-renowned Eastman Department of Dentistry/Eastman Dental receives more than 700 applications for just 48 resident positions, allowing the best and the brightest to be selected. As a result, many patients choose Eastman Department of Dentistry/Eastman Dental Center because the cost of the care provided by supervised, highly qualified post-doctoral residents is discounted in consideration of their participation in the educational process and research.

For more information regarding the research studies, please call Stacie Ellis at 273-4489or email her at Stacie_ellis@urmc.rochester.edu.

Eastman Dental Featured on R News

More People are Considering Cosmetic Dentistry

For decades those with severe dental problems have been turning to cosmetic dentistry for help. Recently even those with moderate flaws are doing the same. From teeth whiting to caps and bridges cosmetic dentistry is becoming big business. But those who turn to this type of treatment say finding the right dentist is crucial.

Sitting through dental work can be difficult. For Alex Picciano it’s worth it.

“I don’t think anyone should let themselves go. At any age,” Picciano said.

After having his teeth removed, Picciano wanted something secure.

“If you’re happy go ahead with dentures. I would never be happy with dentures,” said Picciano.

Thirteen crowns and six veneers later Picciano also has something that looks good.

“I like to make people happy and the first thing when I look to a person, I look to the smile,” Dr. Alina Dellanzo.

After studying at NYU, Dellanzo is picking up specialty training at the Eastman Dental Center in Rochester.

“Cosmetic dentistry, implant dentistry, veneers, the extreme makeover that you see on TV, that’s what we do,” Dr. Carlo Ercoli.

With 30 percent of all dental work now considered cosmetic dentists trained in this area are in demand.

“It’s the confidence in the person you’re going to. And I have a lot of confidence in her,” said Picciano said.

So much confidence Picciano was willing to drive all the way from Manhattan so Dr. Dellanzo could finish the job.

“I wasn’t aware how far it was. But I’m not unhappy about coming here,” Picciano said.

Even with the 640 mile trip Picciano is saving money.

“Even more than double,” said Picciano.

And even with a few more treatments left to go, Picciano likes the way he looks and feels.

“I know that people take these things out of their mouth and put them in glasses at night. I didn’t want to go through that,” Picciano added.

by Casey J. Bortnick
Photo by Todd Krupa
Published Feb 27, 2009

http://www.rnews.com/Story_2004.cfm?ID=69810&rnews_story_type=62&category=10

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Eastman Dental’s Holly Barone Earns Achievement Award

Eastman Dental Center’s Holly Barone, senior operations administrator for Community Dentistry & Oral Disease Prevention, has earned a Rochester Business Journal Health Care Achievement Award in the Management category.

This prestigious award recognizes excellence, promotes innovation and honors the efforts of individuals and organizations that are making a significant impact on the quality of health care in Rochester.

“Holly’s management and leadership of our outreach programs have been integral in providing access and oral health care to thousands of indigent, homeless, medically-compromised and geographically isolated patients in the Greater Rochester community,” said Dr. Cyril Meyerowitz, director of Eastman Dental Center. “When she started her career, the outreach program consisted of two SMILEmobiles and eight employees. Thanks to her efforts, today we have six sites with more than 50 employees providing nearly 30,000 patient visits a year to the neediest in our community.”

Donna Hill, R.N. Ph.D., Rochester City School District Coordinator for School Health Services, said that under Barone’s management, the SMILEmobile program has thrived.
“Ms. Barone has organized the infrastructure for the program, been instrumental in seeking and receiving funding and has been involved in policy development and guidelines for her staff,” Hill said. “In her quiet and respectful way, she has opened doors for preventative and curative dental care in our District.”

Barone is also credited with being a lead player in establishing a first-of-its-kind project to reduce dental access disparities by developing meaningful partnerships with community groups. In addition, she was able to get several EDC outreach sites designated as Dental Health Professional Shortage Areas, making faculty eligible for loan forgiveness, which in turn greatly improves provider recruitment and retention, and thereby providing better service to underserved areas.

“She has exposed residents in Eastman Dental Center’s advanced and specialty training programs to the acute needs of so many underserved children,” said Dr. Ronald Billings, a professor in the Department of Dentistry and former EDC director. “Many of these residents have been inspired to work in the outreach facilities and others have returned to volunteer their services after completing their training.”

EDC’s Director of Finance & Administration, John Borrelli, said that Barone’s extensive experience in clinical operations and understanding of the complexities involved in providing care in outreach facilities has been invaluable. “She also has demonstrated the importance of fiscal viability and continually strives to improve the margin of the Community Dentistry and Oral Disease Prevention Division during these difficult economic times by introducing innovative processes to reduce costs and enhance revenue,” he added.

“Holly has been dynamic, articulate and persistent in advocating for underserved populations,” added Lenora Colaruotolo, a social worker for the University of Rochester Medical Center. “She is respected for her contributions, recognized for proficiency and admired for her energy and enthusiasm, and models professional excellence in her competence, integrity and service.”

Barone will be featured in the Health Care supplement of the March 13 issue of Rochester Business Journal, and will be honored at a luncheon March 19.

LeChase and Friedlander Join Eastman Dental Foundation Board

R. Wayne LeChase and Roger B. Friedlander have joined the Eastman Dental Center Foundation Board of Directors.

LeChase, of Webster, is chairman and managing partner of LeChase Construction Services, and has more than 20 years of executive leadership experience. Previously, he was a partner in the law firm of LaDuca, Offen and LeChase, and also practiced law at the offices of Johnson, Reif and Mullan.

Among the many awards he’s earned for community service and excellence, LeChase was inducted into the Rochester Business Hall of Fame, a program created to recognize exemplary leaders who have made outstanding and enduring contributions to business and community in the Greater Rochester region. He is also a member of the University of Rochester Board of Trustees.

Roger B. Friedlander, of Brighton, has actively served on both the University of Rochester Board of Trustees and its Medical Center Board of Directors for 11years. As a Trustee, he has chaired and served on several committees for fund raising, facilities and student affairs. A former chair of the Medical Center Board, he served on the quality of care, finance and facilities committees, as well as the Golisano Children’s Hospital at Strong Advisory Board. Friedlander was the co-founder of Spectrum Office Products which was acquired by Staples, Inc. in 1994. A University of Rochester alumnus, he earned the J.S. Armstrong ’54 Alumni Service Award in 2003.

Lechase and Friedlander will advise Eastman Dental Center senior leadership, monitor implementation of Dentistry’s strategic plan, as well as advocate for and support the Center’s mission for education, clinical and research excellence.

Cleft Lip and Palate Babies Benefit at URMC/Eastman Dental Center

Lindsay Ebbrecht, 27, learned at an ultrasound appointment during her 16th week of pregnancy that her baby had a cleft lip and palate.

Sierra’s mother, Lindsay Ebbrecht, drives 2 hours each week to Eastman Dental Center to have her NAM adjusted by pediatric dentist Dr. Karp and resident Dr. Avani Patel.

“I was in shock for a week or so, and a little nervous, because sometimes cleft lip and palate is associated with another syndrome,” she said. “I was so relieved when I found out Sierra didn’t have any other conditions; I knew cleft lip and palate was a fixable situation.” Thus, she began what she refers to as her second career, spending every night after work on the computer learning all about cleft lip and palate and the various options for treatment. She read every medical article she could find as well as websites and blogs from other parents who were already on the journey she was about to begin.

Once she had all the facts and information, she had no doubt she wanted Sierra to wear a NAM, or a nasoalveolar molding appliance. The NAM is a retainer of sorts that fits into the baby’s mouth and later her nose to gradually reduce the size of the gap before the first corrective surgery, which occurs anytime after baby reaches 10 pounds. The team from Golisano Cleft and Craniofacial Center at the University of Rochester Medical Center, including Eastman Dental Center, is the only group in the area who performs this molding technique.

When Sierra was just 10 days old, she had an impression of her mouth and nose and began treatment shortly thereafter.

Since then, Lindsay has driven two hours from her hometown Elmira to Eastman Dental Center every week to have Sierra’s NAM adjusted.

At home, taking care of Sierra and managing her NAM can be labor intensive. As a result, Lindsay quit her job to dedicate her time to caring for Sierra, but she says, it’s well worth the effort.

Sierra’s NAM (see photo above) has helped close the gap more than 13 mm in less than 3 months. Her right nostril, originally flat at birth, is now taking shape.

“Children who use the NAM likely benefit from enhanced feeding as an infant, a much shorter initial surgery at about four months of age, a potential for fewer subsequent surgeries, and significantly less scarring around her surgically repaired lip and nose,” explained Dr. Jeffrey Karp, EDC pediatric dentist and cleft lip and palate expert. Thanks to this device, baby Sierra’s gap has closed from its original 17mm at birth to 4 mm at 3 months of age. Her right nostril, originally flat at birth, is now taking shape, as well. “Most importantly,” Dr. Karp added, “Lindsay is able to take an active role in improving Sierra’s surgical result”.

Also Featured on R-News

New Dental Procedure Gives Patients Hope

by Casey J. Bortnick
Published Dec 27, 2008

It’s called cleft lip and palate, a condition that affects 1 in 1000 babies.

It occurs when the tissue in the developing mouth and the palate don’t fuse together properly. The condition can lead to serious abnormalities and can only be corrected with surgery. But a relatively new dental procedure can improve surgical results.

“It’s a pain in the butt most days, and she hates it,” said Lindsay Ebbrecht.

Ebbrecht’s three month old daughter, Sierra, was born with cleft lip and plate. “It’s not an ideal situation. No one wants to hear that there’s something wrong,” Ebbrecht said.

When Sierra was born her cleft was 17 millimeters wide. A gap that needed to be closed before she could even be considered for plastic surgery. “

Cleft lip and palate is certainly treatable,” said Dr. Jeff Karp of the Eastman Dental Center.

Sierra’s mom drives from Elmira to Rochester once a week for treatment.

Dr. Jeff Karp fitted Sierra with nam, a molding fitted for the babies mouth. It works by moving segments of the gum closer together.

“To make the cleft gap less severe, to help to align the nose before surgery, and it really makes the surgical outcome a lot more aesthetic,” Karp said.

In just a short amount of time, Sierra’s nam has reduced her cleft to a few centimeters.

For Sierra and her family, there’s been some sleepless nights along the way.

“But it’s definitely worth it for the long run. Although she doesn’t know it now. She gets really mad,” said Ebbrecht. But there’s still a long way to go. Years of management and follow up surgeries are still ahead.

Sierra’s mom says that shouldn’t be a problem.

“All things considered, shes been quite the little trooper,”.

© 2008 Time Warner Cable Rochester, NY All Rights Reserved

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Eastman Dental’s Pediatric Dentistry Patients Have Fun Playing On The New Equipment Purchased By Funds Donated to Sponsor-A-Smile.

Your Support Has Sponsored Countless Smiles!

In the three and a half years since the Sponsor-a-Smile program has existed, countless families have been helped.

“Each dollar donated can go a long way toward making a real difference in the lives of our patients,” said Lenora Colaruotolo, Eastman Dental Center social worker who helped develop and launch the program with help from Eastman’s Program Development Office. This hardship fund initiative was the first ever attempt to raise funds for use at the discretion of social work staff to address unmet financial needs of EDC’s patient population.

Over the last 12 months, nearly $2, 500 has been raised, used for many different purposes.

“We purchased new, sturdy, age-appropriate play equipment, and ordered five subscriptions to children’s magazines for the busy pediatric waiting room,” Colaruotolo said. “Now our pediatric patient population has additional toys to play with that encourages development of fine motor skills while creating an environment that promotes literacy and positive social interaction.”

In addition, 22 highly anxious children were able to undergo treatment only because Sponsor-A-Smile covered the cost of the prescribed medication not covered by Medicaid Insurance.

Enough funds were also available to help defray transportation costs to bring 20 pediatric patient families to the Eastman Dental Center and purchase 500 toothbrushes and toothpaste to distribute to our patients and their families.

“This hardship fund is near depleted, and your help is requested, needed, and greatly appreciated,” said Colaruotolo. The next goal is to create a children’s library of sorts for our pediatric patients. With a sufficient amount of money raised, Colaruotolo will purchase additional magazine and newspaper subscriptions, educational videos and books, along with shelving, and even small tables and chairs for the children to sit at while they read.

I hope you’ll consider supporting Sponsor-A-Smile,” Colaruotolo added. “Children learn through repetition, including education about good oral health habits. Having a library of videos and books available that emphasize and encourage these important messages to parents and children is a continuation of our mission at Eastman Dental Center.”

To donate, gifts may be sent to: Dentistry Development Office at the University of Rochester, 300 East River Road, P.O. Box 278996, Rochester, NY 14627, or to make a gift directly, to Dentistry’s secure on-line site: Make A Gift to Sponsor A Smile and direct your gift to Sponsor-A-Smile. Payroll deduction is also available.

Testimonial From Grateful EDC Patient

“There aren’t any words that can truly express my gratitude towards the Eastman Dental Staff. I am honored to have made their acquaintance and must say I am glad they have chosen the profession they have. You have an amazing staff. Thank you doesn’t seem enough but Thank you!”
_______________________________________________________
My name is Natasha Sealy-Robinson and I am writing to inform you of my recent experience at Eastman Dental. I have three children two of them require extensive dental work–Justin, age 9 and Tiffani, age 8. Justin was assigned to Dr. Terry Farquhar and Tiffani was assigned to Dr. Gill.

Both doctors dealt with me very professionally but more importantly took the time to connect with my children who have had scary dental experiences in the past.

Dr. Gill explained to me that he was going to put Tiffani on the orthodontic waiting list which I had no idea even existed. Dr. Farquhar did the same.

Dr. Farquhar noticed that I was a self pay client and took the time to explain to me not only what needed to be done but the cost. He could have simply referred me to Child Health Plus by giving me a number to call but he went above and beyond and initiated the process on his own by contacting [social worker] Leonora Colaruotolo.

Mrs. Colaruotolo made sure she got in contact with me via my cell phone, work and email. She took the time to thoroughly explain the Child Health Plus process and told me to personally contact her if I ran into any stumbling blocks.

After several calls into the Child Health Plus facilitator with no success and my Justin having a dental emergency (a boil on his gum caused by an infected tooth), I called Mrs. Colaruotolo to see if there was anything that she could do. She promptly called me back and as promised, she assisted me by putting me in contact with [social worker] Kim Flint, who met me in the lobby and made calls and emails on my behalf.

Both Mrs. Colaruotolo and Mrs. Flint came to the examination room to see how my son was doing. As a result of Mrs. Colaruotolo and Mrs. Flint efforts I received a call from the Child Health Plus facilitator the very next day.

Regardless of the outcome I am extremely grateful of the help I have received thus far. My son was treated by Dr. Oster who was awesome to say the least. He administered anesthesia and pulled my son’s tooth out all before his tears could hit his cheek.

There aren’t any words that can truly express my gratitude towards the Eastman Dental Staff. I am honored to have made their acquaintance and must say I am glad they have chosen the profession they have. You have an amazing staff. Thank you doesn’t seem enough but Thank you!!

Kind Regards,

Natasha Sealy-Robinson

New York State Dental Foundation’s Deans Award Recognizes Five Outstanding Dental Students

Maricelle Uy Abayon, Eastman Dental Center.

Graduating as one of the highest ranking students at the University of the Philippines and ranked highest in her dental school class, it would seem there is little left for Dr. Abayon to achieve. Yet, in less than two years at Eastman Dental Center, Dr. Abayon has demonstrated an ability to form excellent relationships with patients, administrators, staff and faculty, while, at the same time, performing at the highest level in the difficult master of science program at the University of Rochester.

The advanced education in general dentistry program at Eastman has always been considered demanding because of the required literature reviews, case presentations, research seminars and academic classes, to say nothing of the patient component of the program. Dr. Abayon has been an active participant in all of these areas and still finds time to lend a hand to others. She has never refused a request to help with emergency patients or to assist another resident in a difficult procedure. Dr. Abayon’s unique ability to recognize the social, economic, psychological, medical and financial impediments to successful dental treatment for her patients, and to do so with both an air of confidence and a sense of humility, evidence a maturity far beyond her years.

Copyright, New York State Dental Journal

Announcement from EDC’s Division of Pediatric Dentistry

Eastman Dental Center (EDC) is pleased to announce that Dr. Jeffrey Karp has been appointed the Ambulatory Clinical Director of EDC’s Pediatric Dental Services.  In this role Dr. Karp will report to Dr. Robert Berrkowitz, Chair, Pediatric Dentistry and work closely with Marianne Frail to ensure effective operations of the Pediatric Dental Service.  Dr. Karp is an enthusiastic and accomplished individual who will bring much to the role.  Please join us in welcoming him to this position.

Eastman is Awarded $1.6M Grant to Prevent Cavities

The National Institutes of Health has awarded Eastman Dental Center’s Hyun (Michel) Koo, D.D.S, Ph.D., $1.6 million to continue his work on preventing dental caries, the single most prevalent and costly oral infectious disease in the U.S.

Dental caries (decay) results from the interaction of specific bacteria (such as Streptococcus mutans) with dietary sugars. Streptococcus mutans produces polymers, using sucrose to help them, and other pathogens, to cling to tooth surfaces, forming biofilms, known as dental plaque. Basically, once the bacteria are firmly attached on the tooth surface, it creates cavities by eating sugars and then excreting acids that cause dental decay.

To date, Koo’s work has focused on finding novel therapeutic substances from natural sources that could prevent bacteria from forming dental biofilm by disrupting the production of polymers, as well as acids. Koo’s research team at Eastman Dental Center, part of the University of Rochester Medical Center, has discovered that specific compounds in cranberry and red wine grapes may significantly reduce the ability of bacteria to form plaque and cause cavities.

Most recently, Koo and his team have identified a novel strategy to reduce the development and virulence of dental biofilms and caries by combining two naturally occurring anti-biofilm molecules with fluoride, which is already well known to prevent cavities.

The NIH grant will allow Koo to continue his work analyzing how such combination therapy will affect the ability of bacteria to produce polymers and acids with the goal of preventing dental biofilm before it occurs. Koo will take a multi-disciplinary approach to identify the most effective dosage and the mode of action of this therapeutic approach, which may also reduce the level of fluoride needed.

“By integrating biochemical and molecular techniques with an in vivo model of dental caries, we will better understand how these compounds affect plaque development and expand their potential usefulness to prevent plaque related diseases in humans,” Koo said.

Koo received his Ph.D. degree from the State University of Campinas, Brazil, in 1999; his M.S. in 1996 from the State University of Campinas, College of Food Engineering in Brazil; and his D.D.S. degree in 1993 from the State University of Sao Paulo, Brazil. He was a postdoctoral fellow in oral biology at the Center for Oral Biology at the University of Rochester Medical Center. Koo joined the Eastman Department of Dentistry faculty in 2002 as an assistant professor.

Dental care lags among many Rochester children

The following article appeared in Rochester’s Democrat and Chronicle on October 9, 2008.

Justina Wang
Staff writer

Thousands of Rochester-area children enrolled in Medicaid have not seen a dentist in years, and there’s no easy way to find the few pediatric dental offices that will accept them as patients.

The limited access has had an impact. According to a nationwide report released last month by the Government Accountability Office, children on Medicaid are nearly twice as likely as other youths to have dental disease, and one in eight has never seen a dentist. Locally, between 10 percent and 54 percent of children enrolled in the two Medicaid managed care plans that provide dental coverage in Monroe County — Excellus’ BlueCross BlueShield and Fidelis Care — have seen a dentist in the last year, according to state data.

“There is so much unmet need in these children,” said Dr. Cyril Meyerowitz, director of the University of Rochester Medical Center’s Eastman Dental Center. “You find very few children who don’t have (tooth) decay in that population, and it’s very alarming.”

In spite of the concern, low-income parents trying to find places to send their children for dental checkups cannot get a comprehensive list of dentists who accept Medicaid from any official resource: Not from the Monroe County health department, the state health department, the county department of human services and Medicaid office, the local division of the American Dental Association, or from either of the two managed care plans that provide Medicaid dental coverage in Monroe County.

And families that call every pediatric dental office individually to ask whether they’ll take their coverage will run into more barriers.

Of the 31 pediatric dentists listed in Monroe County by the New York State Dental Association, eight said they are accepting new Medicaid patients. Most of those offices are part of hospital- or community-based health clinics, like Eastman, which sees most of the area’s Medicaid patients.

“There are pediatric dentists in Rochester, a lot of them in the Yellow Pages,” said Dr. Meggy Kemshetti, pediatric dentist at the Anthony Jordan Health Center, which runs a dental clinic for low-income patients. “But it’s difficult to find one that will see a Medicaid patient.”

Monroe County has about 500 dentists, and the New York Medicaid helpline provides a list of 21 local general dentistry offices that supposedly accept the state-administered coverage. But when called, at least four of those offices said they do not take Medicaid, one was not accepting new patients, two had months-long wait lists, and seven of the listed phone numbers were wrong.

Issues of access

Rochester mother Melissa Parrish had always worried about dental care for her two sons, who are enrolled in Medicaid. She didn’t want them to have the cavities she had as a child, and wondered where to send them for their recommended six-month checkups. After a social worker referred her to the Eastman Dental Center several years ago, she took her 6- and 9-year-old boys for their first dentist visit and was distressed to find out that her younger son had already developed a cavity. “Early dental hygiene care is important to me,” she said. “I want to get a jump on stuff early.”

According to the Finger Lakes Health Systems Agency, there is one dentist who accepts Medicaid for every 6,744 people in the city’s low-income areas. Dentists say the Medicaid paperwork is overwhelming and that they wait months for reimbursement, which often doesn’t pay as well as private insurance companies.

“There’s a lot of paperwork, more so than your average insurance company,” said Dr. William Molak, a general dentist in Greece. “It’s a hindrance to a lot of dentists because they’re not being reimbursed fairly, and they don’t want any part of it.”

The problems of access gained renewed attention as a state law went into effect this fall, requiring schools to ask students in certain grades to provide certificates that indicate they have seen dentists.

In the Rochester School District, where 88 percent of students are low-income, officials said they have received very few of the certificates. Nurses have tried to refer families to dental offices, using a list of about 25 dentists in Monroe County who supposedly accept Medicaid, said Dr. Donna Hill, district student health coordinator. But the roster is old, and many of the offices no longer take the coverage or have wait lists.

Spurred by the new mandate, the Seventh District Dental Society, the local American Dental Association division, is working with the state health department to compile a list of dentists accepting Medicaid in Monroe County. But the task hasn’t been easy, said Seventh District executive director Lori Bowerman.

Several private dentists in the area say they would accept Medicaid for existing patients whose insurance changes, or for certain children, like those with developmental disabilities. But few agree to new patients, and many are reluctant to publicize that they take the coverage.

“The phones would be flooded,” said Dr. David Durr, of Greece Pediatric Dentistry, where Medicaid is accepted only for existing patients. “We’re not primarily Medicaid, but we’re trying to continue to help families that we have going through hard times.”

Local resources

While no roster of dentists accepting Medicaid is easily accessible, the state health department and the New York State Oral Health Technical Assistance Center offer a list of local dental clinics that treat low-income families. The Eastman Smilemobile also provides dental services to low-income children in a van parked outside local schools, and the Eastman Dental Center recently received a $3.9 million state grant to add six treatment rooms and an urgent-care clinic to take in more underserved patients.

However stark the problems in Rochester, most local dentists agree that the issues are even more troubling in surrounding rural counties where children on Medicaid have fewer resources.

Linda Voith drives two hours from her home in Allegany County every time her 15-year-old daughter has an appointment at Eastman — it’s the only office she could find that would accept Medicaid and handle the complexities of her teen’s dental care.

“I have to drive here,” she said. “I called just about everybody I could think of and nobody would take Medicaid.”

Dr. Charles Forte of Unity Dental Group in Penfield sees Medicaid patients from Wayne, Livingston, Seneca and other counties. “Rochester’s actually fortunate in the fact that it’s probably got more Medicaid providers than a lot of those areas.”

The new state law regarding dental certificates in schools has “caused near chaos in Wayne County because there’s no way to do this” in an area where so few dentists take Medicaid, said Emilie Sisson, program manager of the Wayne County Rural Health Network. The county recently opened its first dental clinic, which will offer free screenings one day a week for the uninsured and underinsured. But besides the clinic, only one small dental office in the county is accepting new Medicaid patients, Sisson said.

Other problems

In spite of some efforts in Monroe County to offer care to low-income children, dentists say problems persist because access isn’t the only issue. Although the Smilemobile van offers dental checkups outside 19 of 39 city elementary schools, Meyerowitz estimates the program only reaches 30 percent of eligible children because parents don’t sign permission slips.

Immigrant families from cultures that don’t emphasize dental care or poor parents who have grown up with few dentist visits often have many concerns that come before oral health, experts say.

“Poverty discourages going to the dentist,” Hill said. “The first need in a family is not going to be dental care if there’s still a need for food and shelter.”

Among the needs that most directly hinder dental care is the lack of transportation.

“If you don’t have a working car and you’re miles away from where your kids have an appointment, you have to find a way to get there,” said Dr. Lynne Halik, a pediatric dentist in Bushnell’s Basin. “Taking public transportation can take the whole day to get to an appointment. It can be overwhelming.”

Because of that, Medicaid patients often miss appointments, another factor that has discouraged some dentists from accepting them, Halik said.

For children who don’t receive regular dental checkups, dentist visits are reserved for when severe problems develop. Dentists say they often see Medicaid children too late, when decay could have been prevented, teeth saved from extraction and chronic infections avoided. Loss of baby teeth means fewer spaces for permanent teeth, and children who don’t have proper dental care have poorer oral hygiene and are less likely to visit dentists as adults.

“You set a pattern for a lifetime,” said Dr. Richard Speisman, chief of Rochester General Hospital’s department of dentistry. Because of some efforts by local clinic workers to reach out to families at health fairs and through city schools, more low-income children are coming in for preventive care, Speisman said. “But it’s not as quick or as rapid a change as we like to see.”

And in spite of some improvement, tooth decay has become more prevalent in children about 2 to 8 years old — a sign that complex issues have not been fully addressed, Meyerowitz said.

“We’ve looked at this for many, many years, and we still don’t have a clear answer,” Meyerowitz said. “It could be that parents don’t see this as a high priority … it could be whole other social barriers in terms of people trying to access care. But it’s a cascading series of problems that most of us wouldn’t want for our children.”

JUWANG@DemocratandChronicle.com

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1.02.05

Dr. Jack Caton Elected Vice President of American Academy of Periodontology Foundation Board

The American Academy of Periodontology (AAP) Foundation board of directors elected Jack Caton, D.D.S., M.S., of Pittsford, New York, as vice president, at its annual meeting in September. Dr. Caton is chair, Division of Periodontics, Eastman Dental Center, within the University of Rochester Medical Center.

Dr. Caton has served several terms with the Foundation board and at the time of his election in 2002 was chair of the Foundation’s Gerald M. Bowers Endowment Fund for the American Board of Periodontology. Under Dr. Caton’s leadership, the Bowers Endowment Fund exceeded its $1.5M goal. In 2007 he was appointed to serve as Co-chair of the AAPF Education Campaign Task Force.

Dr. Caton has served as president of the American Academy of Periodontology, director and chairman of the American Board of Periodontology, and director for the Monroe County Dental Society and the Seventh District Dental Society of New York. He received his dental degree from the University of California in San Francisco, his certificate in advanced general dentistry from the U.S. Army, and his postdoctoral training certification from Eastman Dental Center. Dr. Caton also holds an M.S. from the University of Rochester.

The American Academy of Periodontology Foundation is dedicated to improving the periodontal and general health of the public through increasing public and professional knowledge of periodontal disease and its therapies, stimulating and supporting basic and clinical research to generate new knowledge and enhancing educational programs at all levels to create opportunities in periodontal education and practice.

737 N. Michigan Avenue, Suite 800 Chicago, IL 60611
(800) 282-4867 Fax: (312) 573-3272 www.perio.org

7A4D2F19-0F4B-7C0B-06F4-2DAA5582DDA6

1.02.05

NYS Awards Eastman Dental Center $3.9 Million to Increase Access

Eastman Dental Center, of the University of Rochester Medical Center, has been awarded a $3.9 million state grant to increase access and capacity for Rochester’s underserved residents. Golisano Children’s Hospital at Strong has been awarded $500,000 to optimize health care access through telemedicine.

Eastman Dental Center is the largest provider of oral health care to the underserved in the Rochester region. Care demands and dental emergencies have increased significantly since Genesee Hospital and Pluta Dental Center closed, leaving an overwhelming unmet need for early and regular oral health care among this population. Rochester has the highest rate of child poverty in New York, representing a significant challenge to improving overall health and well being.

“These funds will allow us to increase capacity and upgrade our facilities to meet this increasing demand for oral health care throughout our community,” said Dr. Cyril Meyerowitz, director of Eastman Dental Center.

As part of a broader re-engineering project, over the next three years, Eastman Dental Center will add six new treatment rooms as well as establish an Urgent Dental Care Clinic at its main campus on Elmwood Avenue. In addition, EDC will add four treatment rooms to its Downtown Oral Health Center, doubling its capacity to 8,600 visits per year.

“By expanding and reconfiguring our operations, we can now greatly improve our efficiency, and foster regular dental and medical care for all our patients, in an effort to keep our community healthy,” Meyerowitz said.

The critical importance of good oral health continues to gain national recognition as recent research shows links between oral health and heart health, diabetes, and low birth weight. Oral health problems are also one of the leading causes of absenteeism from school.

Golisano Children’s Hospital’s Health-e-Access program also received a $500,000 HEAL grant to serve more residents of Rochester’s poorest neighborhoods with a telemedicine system that can diagnose and treat common childhood illnesses. This includes using mobile technology to serve additional school and childcare-based telemedicine sites and inviting all Rochester-area primary care practices to participate in the program.

In addition, this grant will allow Health-e-Access to expand by including after-hours care through two inner city neighborhood-based sites. When parents call their children’s physicians after hours and reach the existing Rochester Community Pediatric Telephone Triage system, they will have an additional choice to use telemedicine through a conveniently located site in their immediate neighborhood.

The grants are part of HEAL NY, which represents $280 million awarded to New York State non-profit clinics, hospitals, health departments and nursing homes to improve facilities and increase efficiency.Eastman Dental Center’s grant is the largest award in the central region.

“HEAL NY projects support the core of New York’s health care reforms by strengthening primary care, supporting further consolidations, and further implementing Berger commission recommendations to bring efficiency and effectiveness to New York’s health care system,” said Governor David A. Paterson.

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1.02.05

New Study Proves that Pain is Not a Symptom of Arthritis, Pain Causes Arthritis

Pain is more than a symptom of osteoarthritis, it is an inherent and damaging part of the disease itself, according to a study published today in journal Arthritis and Rheumatism.  More specifically, the study revealed that pain signals originating in arthritic joints, and the biochemical processing of those signals as they reach the spinal cord, worsen and expand arthritis. In addition, researchers found that nerve pathways carrying pain signals transfer inflammation from arthritic joints to the spine and back again, causing disease at both ends.

Technically, pain is a patient’s conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides strong evidence that two-way, nociceptive “crosstalk” may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.

Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer’s disease, dementia and multiple sclerosis. Armed with the results, researchers have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients lose the protective cushion between bones in weight-bearing joints like knees and hips.

“Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, an inevitable part of aging,” said Stephanos Kyrkanides, D.D.S., Ph.D., the J. Daniel Subtelny professor and chair of Orthodontics, and Eastman Dental Center associate research director, within the University of Rochester Medical Center. “Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing, and suggests the mechanisms behind the effect,” said Kyrkanides, whose work on genetics in dentistry led to broader applications. The common ground between arthritis and dentistry: the jaw joint is a common site of arthritic pain.

Study Details

Past studies have shown that specific nerve pathways along which pain signals travel repeatedly become more sensitive to pain signals with each use. This may be a part of ancient survival skill (if that hurt once, don’t do it again). Secondly, pain has long been associated with inflammation (swelling and fever).

In fact, past research has shown that the same chemicals that cause inflammation also cause the sensation of pain and hyper-sensitivity to pain if injected. Kyrkanides’ work centers around one such pro-inflammatory, signaling chemical called Interleukin 1-beta (IL-1β), which helps to ramp up the bodies attack on an infection.

Specifically, Kyrkanides’ team genetically engineered a mouse where they could turn up on command the production of IL-1β in the jaw joint, a common site of arthritis. Experiments showed for the first time that turning up in a peripheral joint caused higher levels of to be produced in the dorsal horns of the spinal cord as well.

Using a second, even more elaborately engineered mouse model, the team also demonstrated for the first time that creating higher levels of in cells called astrocytes in the spinal cord caused more osteoarthritic symptoms in joints. Past studies had shown astrocytes, non-nerve cells (glia) in the central nervous system that provide support for the spinal cord and brain, also serve as the immune cells of CNS organs. Among other things, they release cytokines like to fight disease when triggered. The same cytokines released from CNS glia may also be released from neurons in joints, possibly explaining how crosstalk carries pain, inflammation and hyper-sensitivity back and forth.

In both mouse models, experimental techniques that shut down IL-1β signaling reversed the crosstalk effects. Specifically, researchers used a molecule, IL-1RA, known to inhibit the ability of IL-1β to link up with its receptors on nerve cells. Existing drugs (e.g. Kineret® (anakinra), made by Amgen and indicated for rheumatoid arthritis) act like IL-1RA to block the ability IL-1β to send a pain signal through its specific nerve cell receptor, and Kyrkanides’ group is exploring a new use for them as osteoarthritis treatment.

The implications of this process go further, however, because the cells surrounding sensory nerve cell pathways too can be affected by crosstalk. If 10 astrocytes secrete IL-1β in response to a pain impulse, Kyrkanides said, perhaps 1,000 adjacent cells will be affected, greatly expanding the field of inflammation. Spinal cord astrocytes are surrounded by sensory nerve cells that connect to other areas of the periphery, further expanding the effect. According to Kyrkanides’ model, increased inflammation by in the central nervous system can then send signals back down the nerve pathways to the joints, causing the release of inflammatory factors there.

Among the proposed, inflammatory factors is calcitonin gene related peptide (CGRP). The team observed higher levels calcitonin-gene related peptide (CGRP) production in primary sensory fibers in the same regions where IL-1β levels rose, and the release of IL-1β by sensory neurons may cause the release of CGRP in joints.  Past studies in Kyrkanides reveal that CGRP can also cause cartilage-producing cells (chondrocytes) to mature too quickly and die, a hallmark of osteoarthritis.

Joining Kyrkanides in the publication from the University of Rochester; M. Kerry O’Banion, M.D., Ph.D., Ross Tallents, D.D.S., J. Edward Puzas, Ph.D.and Sabine M. Brouxhon, M.D.  Paolo Fiorentino was a student contributor and Jennie Miller was involved as Kyrkanides’ technical associate.  Maria Piancino led a collaborative effort at the University of Torino, Italy. This work was supported in part by grants from the National Institutes of Health.

Our study results confirm that joints can export inflammation in the form of higher IL-1β along sensory nerve pathways to the spinal cord, and that higher IL-1β inflammation in the spinal cord is sufficient in itself to create osteoarthritis in peripheral joints” Kyrkanides said , “We believe this to be a vitally important process contributing to orthopaedic and neurological diseases in which inflammation is a factor.”

Eastman Dental Center’s Bahreman Honored

Dr. Aliakbar Bahreman, of Brighton, professor of clinical dentistry and orthodontics at Eastman Dental Center at the University of Rochester Medical Center, was honored during a recent visit to Beheshti University in Tehran, Iran, where he was a leader and pioneer in dentistry for nearly 30 years.

Bahreman is the first in dentistry to be awarded Professor Emeritus at Beheshti University. In addition, he was given the highest medal in research for his ongoing work since 1967. He founded and chaired both the pediatrics and orthodontics departments, and also served as dean of the dental school for five years. During that time, he developed postgraduate curricula that were the first of its kind in Iran. He also founded the Iranian Association of Orthodontists and the Dental School Journal.

Since 2003, Dr. Bahreman has served Eastman Dental Center as a full time clinical professor in the orthodontics, pediatric dentistry, and advanced education in general dentistry programs.

Dr. Bahreman has been a member of a number of dental organizations, including the American Association of Orthodontics, World Federation of Orthodontics, and he is a fellow of the International College of Dentists.

Bright Smile Days Initiative

New program connects oral health, graduation
Initiative takes city schools students for regular dentist visits.
By Nate Dougherty
Rochester Business Journal, August 8, 2008

A program run by the Hillside Work-Scholarship Connection is placing an emphasis on oral health to help high school students stay on track toward graduation.

The Bright Smile Days initiative takes students from the Rochester City School District to regular dentist visits for cleanings and doctor check ups. After a pilot program in May at the Eastman Dental Center and another in late July at QDental offices in Irondequoit and Greece, Hillside has plans to extend the visits to all 1,800 students in its programs.

One of the things Hillside works on is the complete student in terms of family, academics, health care and employment,” said Howard Jacobson, vice chairman of the Hillside Work-Scholarship Connection. “We’re working in all those components to have a healthy, educated, job-oriented young person ready to graduate. If a student is not focusing on their health care, when they get sick, when they have a toothache or a bad cavity, they may stay out of school, which means they’re less likely to graduate on time.”

There are plans to have close to 50 students attend dentist visits every weekend once the school years tarts, with each student having a visit every six months, Jacobson said.

For students not used to paying regular attention to their oral health and who may end up in the emergency room for a toothache, Bright Smile Days will help establish a routine, he said. A survey from the visit in May found 70 percent of students who participated do not visit a dentist regularly and 43 percent rated their oral care as fair or poor.

“This sets an example not only for Hillside students but students in the Rochester City School District that they can be empowered to be responsible for taking care of their health and well-being,” Jacobson said. “It’s not just telling them they should, it’s showing them how.”

For Eastman Dental, Bright Smile Days is a continuation of programs aimed at younger children, such as the SMILEmobile Dental Health Program which delivers care to inner-city youth. Bright Smile Days helps them remain focused on their oral health as they get older and have more responsibility for their own care, said Susan Rosenbloom, an administrator in general dentistry at Eastman Dental and liaison with Hillside.
 
During the session held at Eastman Dental in May, a doctor spoke to the participants about the importance of oral health and the problems that can come from a diet with too much sugar.
“I think that getting on the ground level and getting people accustomed to going to the dentist for an appointment might be a bit of a culture change for some, but it does fit in with our overall mission here at Eastman Dental, “ Rosenbloom said. “We feel that by having the dentist talk tot hem and stress the importance of oral health, we’re giving them more than just an initial exam and a hygiene visit.”

natdougherty@rbj.net/585-546-8303
Copyright Rochester Business Journal

EDC’s Caton Receives Award

Dr. Jack Caton, chair and program director of the division of periodontology is the winner of the 2008 Ross Award for Excellence in Clinical Research.  The award is sponsored by the ADA through the ADA Foundation and Johnson & Johnson Consumer and Personal Products Worldwide.

The full story, from the ADA News, may be found here.

EDC Retired Faculty Member Featured in Local Newspaper

Dr. Buddhi Shrestha, former EDC professor and director of community dentistry, was recently featured in the Messenger Post.  Read the full article here.

Convocation 2008 Remembrances

Forty-three dentists received their postdoctoral certificates from the University of Rochester Medical Center Eastman Department of Dentistry.  You can join the festivities that took place in June with a click.

The Gray Areas of Tooth Whitening

Finger Lakes Community Health, May 2008

How much is too much? Though over-the-counter products flood the market, nobody seems to know yet.

Any drugstore or supermarket dental care aisle offers plenty of tooth whitening strips, kits and gels alongside the toothpaste, floss and mouthwash fundamentals for a daily oral health regimen.

But unlike these other dental health products, tooth whitening caries a great deal of uncertainty when users stray from the directions or whiten more frequently than recommended.

That’s why Dr. Kimberly Harms, a consumer advisor to the American Dental Association and a practicing dentist in Farmington, Minn., urges patients to consult with a dentist before using any sort of whitening product.

“We know the tooth enamel can stand bleaching for people who follow the directions,” Harms said. “We don’t know what happens to the tooth enamel when you put too much bleach on it.”

Tooth whitening or bleaching techniques have become extremely popular since their introduction in the late 1980s. Patients can choose between professionally applied whiteners and an array of over-the counter whitening products infiltrating store shelves.

Dr. Hans Malmstrom, chair of the Division of General Dentistry at the University of Rochester Medical Center, said the use of tooth whitening products over the past 10 years has been astronomical and shows no sign of abating.

“What we considered white teeth 10 or 15 years ago is now considered to be very dark teeth,” he said.

While clinical studies have proven strips, gels and other whiteners are both safe and effective; most of these studies are funded by product manufacturers.Packaging labels estimate how long a product’s whitening abilities last, but researchers have virtually no information on what happens when overzealous patients misuse or overuse these whitening methods.

“You are venturing into unknown territory if you don’t follow the directions and you do it at your own risk,” Harms says.

Malmstrom said when it comes to over-the-counter products, toothpaste whiteners don’t have much of an effect and it can take years to see a noticeable color difference. There is more support, however, for the effectiveness of over-the-counter strips.

Nowadays, he thinks more people are trying the over-the-counter products but a significant number still head to the dentist’s office for whitening because they often are not satisfied with the results of products available from the drug store.

According to Malmstrom, whitening does cause a microlevel change in the tooth enamel, but the enamel returns to normal in several weeks. There is no evidence that whitening in recommended amounts causes long-term damage to the enamel, he said.But that may not be the case for those who obsess over white teeth and use whitening products continuously.

“We don’t know obviously what happens in long term cases,” Malmstrom said. “I would not recommend that people do it all the time.”

Every tooth has a nerve at its core, and too much bleach can cause hypersensitivity in that nerve. However mild, temporary sensitivity of the teeth and gums is a common side effect to whitening, both at the dentist’s office and at home.

Like Harms, Malmstrom strongly advises patients to see a dentist before using any whitening products. The dentist will check for cavities or leaking filings, which can increase a patient’s tooth sensitivity during bleaching. Nerve damage is also a risk if there is an open cavity, he said.

Those with sensitive teeth or exposed roots due to gum disease may be discouraged from bleaching because of the risk of greater sensitivity. The whitening process won’t aggravate gum disease, but those patients have a greater chance of pain during bleaching.

Those with cavities will also want them filled first so they’re not prone to sensitivity.

Malmstrom said he also makes it clear to patients who already have filling that they may need to be replaced to match their post-whitened teeth.

“The problem is you can’t predict what shade you will have exactly after the bleaching because everyone responds a little bit differently,” he said. “The shade can be a pretty significant difference.”

Teenagers interested in tooth whitening should consult their dentist to make sure their teeth are ready. In Harms’ office, the rule of thumb is high school students are old enough for whitening procedures around the time they sit for their senior portraits.

Office Options

There are two methods for dentist-assisted whitening. With the first, trays are fabricated so patients can apply the bleaching agent themselves at home over a period of weeks.

The other option is in-office bleaching, in which a significantly stronger concentration of bleaching agent is used two or three times during the one-time visit. Both can reach the same effect, but the one-time office visit offers greater convenience, although Malmstrom said such patients are still usually sent home with bleaching trays to maximize their result.

“Home whitening with the trays is a very good way of doing it because there is a slower conversion and less sensitivity,” Malmstrom said.

Although whitening products have become wildly popular, it’s not yet clear how much whitening is too much. Some people’s teeth are generally more sensitive, while factors such as age, fillings or cavities also can heighten sensitivity.

Harms says the only one-size-fits-all rule of tooth whitening is “if your teeth are hurting, stop.”

This lack of formal guidelines is precisely why Harms wants to know if her patient is contemplating purchasing that box of Crest whitening strips.

“I think sometimes people don’t want to tell their dentist when they are buying something over the counter,” she said. “We see it every day; just talk to your dentist and make sure you get that advice on a personal level.”

As for whether patients should use store-bought whitening products or seek treatment at a dentist office, Harms recommends patients consult their dentist. Over the counter whitening products contain lower levels of peroxide. In–office whitening procedures are administered by a professional, netting results faster but at a much higher cost.

In the Rochester area, Malmstrom estimates the at-home bleaching trays run about $100 to $300 per arch, while the office procedure can run $400 to $800.

As Harms explains it, “You tend to see the cost go up for the convenience of the delivery system.”

The increased interest in tooth whitening and other cosmetic procedures has added a new dimension to the typical dentist’s office. The profession has made great strides in preventing cavities, decay and other tooth diseases, so many dentists have more time to devote to cosmetic procedures. 

While going to the dentist has always held long-term cosmetic benefits, Harms enjoys seeing patients get immediate gratification in the form of a whiter smile.

“They like us more now that we are making them look better,” Harms said of her patients. “Adding the cosmetic part of dentistry and combining it with the restorative part has made it a lot more fun.”

Susan Clark Porter contributed to this report.

Copyright, Finger Lakes Community Health >

Dr. Thierer Named to VP Post for American Dental Education Association

Todd Thierer, DDS, MPH, associate professor in the Eastman Department of Dentistry and director of the General Practice Residency Training Program at the University of Rochester Medical Center, has been named American Dental Education Association vice president for Hospitals and Advanced Education Programs. He has been an officer of the ADEA Postdoctoral Dentistry Section, acting as chair in 2000, and has served on the Administrative Board of the ADEA Council of Hospital and Advanced Education Programs, and serving as its chair in 2006.

Dr. Thierer, of Pittsford, also serves as the medical director of the Eastman Dental Center as well as chief quality officer for Dentistry at the University of Rochester Medical Center and is the director of Ambulatory Dental Services at Strong Memorial Hospital. 

Locally, Dr. Thierer is chair of the Education and Licensure Committee for the Seventh District Dental Society of New York and serves on the Council of Dental Education and Licensure for the New York State Dental Association. Dr. Thierer has served on the Postdoctoral General Dentistry Review Committee for the Commission on Dental Accreditation. 

Update: Eastman Dental Center Open Monday June 9

The Eastman Dental Center has been reopened and is fully operational.  Clean up crews worked all weekend, after an early morning fire on Friday. 

Eastman Dental Center Closed Friday June 6

The Eastman Dental Center at 625 Elmwood Avenue, is closed today as a result of smoke damage from an early-morning electrical fire on the concourse level. Patients with dental appointments at Strong Memorial Hospital are being seen as scheduled. Patients with emergency needs can be seen on the fourth floor of Strong Memorial Hospital (Take the Silver Elevators near the main lobby and parking garage). 

Clean up crews will be working all weekend, and we will resume operations Monday morning. All staff should plan to return to work at that time. Inquiries today, June 6, can be answered when you call 275-0485.  Media inquiries should be directed to 721-0647. The message will be updated regularly.

We apologize for the inconvenience, and thank you for your patience.

A secure choice for denture wearers

06/02/2008
Casey Bortnick, News10Now

For millions of people over 50, wearing dentures can be frustrating.

“It’s difficult to go anywhere and eat and things like that,” said denture wearer Bill Dunn. “You’re just always conscious of them.” 

Dunn had to give up some his favorite foods and his favorite restaurants.  “I didn’t go out as much and when I did, I was very careful about what I ordered.” 

Bill went through two sets of dentures until he discovered another option, through Dr. Hans Malmstrom, of Eastman Dental Center. 

“We place two implants in the front area of the lower jaw,” Dr. Malmstrom said.

Traditional dentures fit over the gums and are loosely held in place. As a patient gets older, the lower jaw bone can wear down. The patient may feel as if the dentures are moving around in their teeth. They feel uncomfortable in social situations. 

The three-part procedure inserts two titanium implants in the lower or upper jaw. The implants lock the dentures in place. They can easily be removed for cleaning.

“No discomfort, nothing,” said Dunn. “It’s the best thing that’s come along in a while.”

Thanks to a grant-funded clinical trial at the University of Rochester Dental Center, Bill only paid a fraction of the cost.

“It was too expensive before,” Dunn said. “It’s like buying a car. This way it worked for me.”

Six months later, Bill says it was well worth the price.

“You can live a normal life; you don’t have to worry about going out and eating. Or anything like that. It just works well.”

Friends of Strong Memorial Hospital Make Donation to Dentistry

Friends of Strong, Strong Memorial Hospital’s volunteer program, generously donated $1,396 to the Eastman Department of Dentistry (EDD).

“With those funds, we were able to purchase a second SAM 3 Articulator with Magnetic Plates,” says Lisa Sansone, senior operations administrator.  “This equipment is crucial in the diagnostic preparation and surgical planning for patients undergoing orthognathic or facial reconstruction surgery.” 

Given the success of the procedure, the demand for this surgery has significantly increased in the last year.  Using this new equipment has had a positive affect on both EDD’s clinical and educational programs.

The Friends of Strong have continued to show their commitment to EDD over the past several years.  This year’s support is deeply appreciated because it benefits EDD patients who are facing reconstructive surgery.

 

Eastman Dental Center’s Carletta Carter Earns National Honor

Eastman Dental Center staff member Carletta Carter, of Rochester, has been named the 2007 Dental Assistant of the Year, a national award sponsored by Colgate.

Carter is the dental assisting supervisor for Eastman Dental’s Community Dentistry and Oral Health Disease Prevention, where she divides her time as the practice manager for the Downtown Clinic in the Sibley’s Tower Building on Main Street, and supervising the department’s dental assistants and dental assisting students.

Carter is a certified and licensed dental assistant, allowing her to perform additional clinical and educational services and oral health presentations.

Carter’s commitment to oral health described in the multiple nominations stood out among the other 200 nominations Colgate received. She completed her clinical training at Eastman Dental Center nearly 30 years ago, and has worked in community dentistry ever since. She is active in American Dental Assistants Association and Dental Assisting National Board, and is president of the Rochester Dental Assisting Society.

“Each day, it’s my goal to work toward the mission of education, patient care and community service,” Carter said, who also has a certificate in counseling and teaching. “I want to empower patients to understand the importance of quality dental care and to actively participate in their own care.”

Carter receives a $5,000 cash award, along with an all-expenses-paid visit to Colgate’s research facility and the Dental Assisting Summit conference, where she’ll be presented a trophy. She will also be featured in an article in the April issue of Inside Dental Assisting magazine.

Overweight Kids Have Fewer Cavities, New Study Shows

Contrary to conventional wisdom, overweight children have fewer cavities and healthier teeth compared to their normal weight peers, according to a study published in this month’s issue of Community Dentistry & Oral Epidemiology.

Surprised researchers at the Eastman Dental Center, part of the University of Rochester Medical Center, conducted a secondary analysis of nearly 18,000 children who participated in two separate National Health and Nutrition Examination Surveys (NHANES III and NHANES 99-02).

The study found no differences in rates of caries (tooth decay) among children ages 2-5 in all weight ranges, while children ages 6-18 who were considered overweight and at risk for becoming overweight showed a decreased risk of caries compared to their normal weight peers.

“We expected to find more oral disease in overweight children of all ages, given the similar causal factors that are generally associated with obesity and caries, said Eastman Dental Center’s Dorota Kopycka-Kedzierawski, DDS, MPH, the lead author. “Our findings raise more questions than answers. For example, are overweight children eating foods higher in fat rather than cavity-causing sugars? Are their diets similar to normal weight peers but lead more sedentary lifestyles? Research to analyze both diet and lifestyle is needed to better understand the results.”

The study defined overweight children as being at the 95th or higher percentile for their age and sex; children at the 85th or higher percentile and less than 95th percentile for their age and sex were defined as at risk for becoming overweight.

See also:
ScienceDaily April 3, 2008

Hagen Identifies Proteins Found in Human Saliva Glands

Fred Hagen, research assistant professor of biochemistry and biophysics, was interviewed about a study he conducted, that identified all of the unique proteins found in human saliva glands: “This is potentially a large field that has many clinical implications in the area of disease diagnostics”, said Hagen. 

Read more about Hagen’s research at MSNBC, New Scientist,  Reuters,  Globe and Mail Canada, among many other publications.

SMILEmobile Featured on R-News

Eastman Dental Center’s SMILEmobile program has been featured on Rochester’s R-News.  The article incluces comments from EDC’s Janice Glen and Dr. Desiree Laracuente.

The article, and link to the video, maybe be accessed here.

EDC featured in WHAM News 13 Story

The Eastman Dental Center was recently featured in  WHAM News 13’s story Dental Care for Kids—Still a Nightmare for Some.

Dentistry Operations Supervisor Receives Board Excellence Award

Lisa Lord, a dental operations supervisor for General Dentistry and Oral and Maxillofacial Surgery, received a Board Excellence Award for Dentistry for consistently displaying a high degree of integrity, responsibility and ambition during her 26 years of service to this department. She is certified as an anesthesia assistant and dental assistant. As a manager, she exhibits creativity and resourcefulness to help make the department more efficient.

Strategic Plan for Dentistry at URMC

Dentistry at the University of Rochester is unique among academic health centers in the United States:  despite the absence of an undergraduate dental school, we have internationally recognized dental residency programs, vibrant oral biology research that is in the top tier of NIH rankings, and robust clinical services in all dental specialties with a strong community orientation.  Read Dentistry’s 2007-2012 stragegic plan here.

Winemaking Waste Proves Effective Against Disease-Causing Bacteria in Early Studies

A class of chemicals in red wine grapes may significantly reduce the ability of bacteria to cause cavities.

The recent study examined the make-up of polyphenols in red wine grape varieties and their ability to interfere with Streptococcus mutans (S. mutans), the bacteria that produces the substances most responsible for tooth decay.  The study was conducted by assistant professor of Dentistry, Dr. Hyun Koo, of the Eastman Department of Dentistry and Center for Oral Biology in collaboration with the New York State Agricultural Experiment Station at Cornell University.

Read the full release here.

“Benefits of Red Wine” also featured on News 10 Whec.com .

Eastman Dental Center Lands $500K Grant for Teledentistry

Eastman Dental Center, at the University of Rochester Medical Center, has landed a five-year, $532,000 grant to explore teledentistry, a novel approach that uses an intraoral camera to image teeth and tooth surfaces. The grant was awarded by the National Institute of Dental and Craniofacial Research, of the National Institutes of Health.

Recent studies by the Center for Disease Control and Prevention showed that tooth decay in young children’s baby teeth is on the rise. Early Childhood Caries is often an acute and debilitating form of tooth decay that, when caught too late, can only be treated in the operating room

Over the next five years, more than 500 preschool children enrolled in six different inner city day care centers will be examined to determine if teledentistry is useful in identifying at-risk children before extensive treatment is needed. The children will receive an initial baseline exam, and then will be re-examined six and 12 months later.

Oral health problems are one of the leading causes of absenteeism from school – 52 million school hours are missed each year by children nationwide. Rochester has the highest rate of child poverty in New York, representing a significant challenge to improving overall health and well being.

“Intervention at an early age is critical,” said Dorota Kopycka-Kedzierawski, DDS, MPH, who is leading the research effort. “Teledentistry can help more children by preventing and detecting early childhood tooth decay.” This technology allows trained personnel to take and transfer digital pictures of a child’s mouth in day care or preschool so they can be reviewed by pediatric dentists remotely. Providers can then recommend next steps and treatment for the child that may have otherwise not happened for months or years.

This effort follows Eastman Dental Center’s successful pilot teledentistry initiative last year, where more than 40 percent of the 200 children ages 1 to 5 screened at inner-city daycare centers had cavities and 95 percent of whom had never seen a dentist.

“Many parents mistakenly think that because baby teeth will fall out, taking care of them isn’t important,” said Kopycka-Kedzierawski. “Nothing could be further from the truth. Baby teeth play an important role as placeholders for permanent teeth, and if they are removed too early, adult teeth may become overcrowded or misaligned. When there is decay in baby teeth, there is a better chance of decay occurring in adult teeth.”

A world leader in residency training and research initiatives, Eastman Dental Center each year treats thousands of Rochester-area patients by providing a full range of general and specialized dentistry including pediatrics, periodontology, oral and maxillofacial surgery, orthodontics and prosthodontics. Established in 1915, the Center is the only major post doctoral dental education, research and clinical institution in the U.S. within an academic medical center. The legacy of George Eastman continues to thrive with its extensive community outreach program helping underserved residents.

Also reported by WHEC TV, WXXI News, Rochester Business Journal, Democrat and Chronicle.

Major Grants Boost University of Rochester’s Geriatric Programs

A three-year $1.5 million grant, Geriatric Training for Physicians, Dentists, and Behavioral and Mental Health Professionals, will provide geriatric training fellowships for physicians, dentists, and mental health professionals to improve access to quality care for older adults. The grant aims to increase the number of skilled clinicians who are also teachers and scholars, who will teach geriatric medicine, dentistry or behavioral/mental health to current and future health care professionals.Read more here.

Eastman Dental Center Unveils New SMILEmobile

New unit increases access for area’s needy children

On Friday, November 16, the Eastman Dental Center unveiled the new Ronald McDonald House Charities SMILEmobile, a dental office on wheels allowing the city’s children increased access to much needed dental care.

Until now, the Eastman Dental Center has had three SMILEmobiles serving preschoolers and elementary students by visiting 15 city schools. Thousands of the underserved and uninsured children need dental care because of decay and infection. On the SMILEmobiles, children receive cleanings, fluoride, sealants and other restorative services. The new Ronald McDonald House Charities SMILEmobile means that 2,400 additional students will now have access to care. Each SMILEmobile is staffed with a dentist, hygienist, dental assistant and administrative coordinator.

Rochester’s inner city has the highest child poverty rate in all of New York, and parts of the city have been declared as having a serious shortage of dentists by the federal government,” said Cyril Meyerowitz, DDS, director of the Eastman Dental Center. “Early intervention is critical—and the SMILEmobiles are a huge part of the solution. Without this effort, there would be more cost to the local health care system, more work and school hours lost and more children suffering.”

Oral health problems are one of the leading causes of absenteeism from school. Research shows links between poor oral health and diabetes, heart disease, and low birth weight.  Recent studies by the Center for Disease Control and Prevention showed that tooth decay in young children’s baby teeth is on the rise. When there’s decay in baby teeth, there’s a better chance of decay occurring in adult teeth.

“Supporting the SMILEmobile program makes perfect sense for us,” said Elsa Steo, board president of the Ronald McDonald House Charities of Rochester, NY, which provided the lead gift for the unit. “Supporting the health and well being of Rochester area children is a wonderful expansion of who we are and what we do…we’re thrilled to be a part of this new SMILEmobile. It’s a win-win for everyone.

The second lead donor is the Daisy Marquis Jones Foundation, a long time supporter of the SMILEmobile program and a satellite clinic at the Daisy Marquis Jones Foundation Outreach Dental Center at School 17. Others include the Joan & Harold Feinbloom Supporting Foundation, the J.M. McDonald Foundation, the Mary S. Mulligan Charitable Trust and the Fred & Floy Willmott Foundation.

The SMILEmobile program began 40 years ago, when EDC and the County Dental Society jointly implemented the “Indigent Children’s Dental Health Care Program,” leading to the first dental mobile unit in New York. Today, the SMILEmobile program is a year-round initiative, serving city schools and rural community sites during the summer.

Pre-Op Antibiotics Prevent Infection for Wisdom Teeth Surgery

Patients who have their wisdom teeth pulled and do not take antibiotics before surgery are twice as likely to get an infection after the surgery than those who take a single dose of antibiotics shortly before surgery, says Eastman Dental Center researchersYan-Fang Ren, DDS, PhD, MPH and Hans Malmstrom, DDS.

Surgical extraction of impacted of wisdom teeth—or third molars—is the procedure carried out most commonly in oral surgery and general dental practices around the world,” said Ren. “Inflammation and infection associated with bacterial contamination are the most common complications after third molar surgery.” Because infection after surgery is usually accompanied by debilitating pain and functional impairment, clinicians have long sought effective ways to prevent complications after third molar surgery.

“Many clinical trials have been conducted in the past to investigate the controversial topic of using antibiotics before wisdom teeth surgery, but most of the published trials involved a sample size too small to support a conclusive outcome,” Ren explained. Through an extensive, meticulous process explained in the Journal, Ren and Malmstrom analyzed 20 published clinical trials involving nearly 3,000 patients.

The findings of this study may serve as a guideline for dentists and oral surgeons for prescribing antibiotics after wisdom teeth surgery. “We do not advocate a universal prescription of antibiotics for every third molar surgery,” Ren explained, “but for patients who have risks for postoperative infections, a single dose of antibiotics before surgery is probably more effective than taking several days of antibiotics after the surgery is completed.” Drs. Ren and Malmstrom hope that this study could help dentists be more purposeful when prescribing antibiotics and to avoid unnecessary antibiotic use.

A world leader in residency training and research initiatives, Eastman Dental Center each year treats thousands of Rochester-area patients by providing a full range of general and specialized dentistry including pediatrics, periodontology, oral and maxillofacial surgery, orthodontics and prosthodontics. Established in 1915, the Eastman Dental Center is the only major post doctoral dental education, research and clinical institution in the U.S. within an academic medical center. The legacy of George Eastman continues to thrive with its extensive community outreach program helping underserved residents.

Resources for Patients

EDC’s Spoon Interviewed on WHEC Channel 10

EDC faculty member and Orthodontist Dr. Mike Spoon was recently interviewed on Channel 10 regarding the new I-cat imaging technology. Read more here.

Stephanos Kyrkanides, DDS, MS, PhD, Appointed Associate Chair/Director of Research

Stephanos Kyrkanides, DDS, MS, PhD, chair of the Division of Orthodontics and Dentofacial Orthopedics has additionally been appointed associate chair/director of research in the Eastman Department of Dentistry and the Eastman Dental Center effective August 1, 2007.

Dr. Kyrkanides received his dental degree in 1991 from the School of Dentistry, National University of Athens in Greece. He completed an Advanced Education in General Dentistry program, a Temporomandibular Joint Dysfunction Fellowship and an Orthodontics and Dentofacial Orthopedics residency at the Eastman Dental Center. In 1999, Dr. Kyrkanides received a Ph.D. from the University of Rochester in Neurobiology and Anatomy.

In this new role as associate chair/director of research, Dr. Kyrkanides will work to facilitate and stimulate research activity and collaboration in the Department and Center. Dr. Kyrkanides is a well-funded and active researcher and has extensive collaborations with investigators in the Medical Center. He will play a significant role in enhancing the translational research capabilities in Dentistry.

Robert J Bray, EDC/URMC Alum

ST. LOUIS—Robert J. Bray, DDS, MS, an orthodontist with offices in Absecon, Somers Point, Marmora and Wildwood, N.J., has been elected secretary-treasurer of the American Association of Orthodontists (AAO).  The announcement was made recently at the AAO’s 107th Annual Session in Seattle.

The AAO is the oldest and largest dental specialty organization in the world.  It is comprised of 15,500 members in the United States, Canada and abroad.  Founded in 1900, the AAO supports research and education leading to quality patient care and promotes increased public awareness of the need for and benefits of orthodontic treatment.

 ”I am honored to serve as AAO secretary-treasurer.  I hope my efforts will contribute to our members and the patients they serve,” Dr. Bray said”.

Dr. Bray is a 1973 graduate of the University , Baltimore College of Dental Surgery.  He received his certificate of orthodontics from the Eastman Dental Center and then received a master’s degree from the University of Rochester Medical Dental School in 1975.  Dr. Bray served as a captain in the U.S. Air Force as chief of orthodontics at Edwards Flight Test Center for two years.  He is in private practice with his partner, E. Gregg Pfund, DDS, MSD. 

Dr. Bray is active in orthodontic education.  He is a clinical associate professor in the Department of Orthodontics at ties as an outstanding alumnus from Eastman Dental Center, University of Rochester Medical Center, Dr. Bray has been invited to return to the department of orthodontics and present during their “Visiting Alumni Lecture Series.”  He has lectured extensively both nationally and internationally on the subjects of clinical practice, practice management, office design and the patient manager system. 

Dr. Bray is a diplomate of The American Board of Orthodontics and a fellow of both the American College of Dentists and the International College of Dentists.  He is vice chair of AAO Services, Inc., the for-profit subsidiary of the AAO.  Dr. Bray is a member of the North Atlantic Component of the Edward H. Angle Society of Orthodontists.

Among his many community activities, Dr. Bray has served as a board member of the American Red Cross and past president of the Brigantine Board of Education.  He has also served on the executive board of the Boy Scouts of America.  Currently, Dr. Bray is a board member of in Somers Point and also serves on the advisory board of the College Preparatory School of Southern New Jersey.

Dr. Bray is a member of the American Dental Association, the American Dental Education Association, the New Jersey Dental Association and the Atlantic Cape May County Dental Society.  He has represented the Middle Atlantic Society of Orthodontists on the AAO Board of Trustees since 2000.

Orthodontists are uniquely qualified to correct improperly aligned teeth and jaws.  They are specialists in the diagnosis, prevention and treatment of dental and facial irregularities.  The American Dental Association requires orthodontists to have at least two academic years of post-doctoral, advanced specialty training from an accredited orthodontic residency program, after graduation from dental school.

National Education Leader to Speak at Eastman Dental Center

A national leader in promoting minority advancement in science and math, Dr. Freeman Hrabowski, III, is the keynote speaker at Eastman Dental Center’s graduation ceremony at 5:15 p.m., June 29, at the Arthur Kornberg Medical Research Building, in the Class of ’62 Auditorium. more…

Center For Oral Biology Wins Major Training Grant Renewal

The Center for Oral Biology within the University of Rochester School of Medicine and Dentistry has been awarded $4 million to expand its renowned training program for oral biologists and dentist-scientists. New, cross-disciplinary training programs will focus on the basic mechanisms that underlie oral diseases to help students prepare for careers within academia, government and industry.  more…

Always Better Series Tackles Tooth Replacement Options

Carlo Ercoli, DDS, chairman of Prosthodontics, and Paul Romano, DDS, clinical associate professor of Periodontology at the University of Rochester Eastman Dental Center, will share the latest information on dental implants that can improve fit and increase quality of life (e.g. enjoyment of meals) via secure denture or fabricate fixed bridges.  more…

Dentistry News Releases 2006

J. Daniel Subtelny honored with 2006 Brophy Distinguished Service Award – July 27, 2006

Digital Cameras and Internet Ease the Pain of Oral Disease – July 20, 2006

Caton Receives State Dental Association Award – July 06, 2006

Department of Dentistry Researchers Earn International Association of Dental Research Award – May 23, 2006

Work on Microbes Earns Honors for Two Dental Researchers – January 17, 2006

Oral Health Alliance strengthens efforts between Eastman Dental Center – January 13, 2006

Eastman Dental Center Foundation, Inc. Board News – January 13, 2006

Lee D. Pollan, DMD, MS, new vice president of the American Association of Oral and Maxillofacial Surgeons – January 13, 2006

Dentistry News Releases 2005

Give Thanks for the Cranberry, Say Dental Researchers – November 23, 2005

American Dental Education Association names Dr. Cyril Meyerowitz to the Commission for Change and Innovation in Dental Education – August 15, 2005

SMILEmobile Program wins New York State award – August 15, 2005

Dentist, Eastman Dental Center board president, avid golfer dies – August 15, 2005

New walkway will connect Eastman Dental Center to the Medical Center Garage – August 15, 2005

Local American Association of Dental Research Awards Given – June 11, 2005

Host Immune Response Linked to the High Risk of Periodontal Disease in Diabetics – June 01, 2005

Reaching out to underserved children in childcare – May 12, 2005

URMC’s Dentistry Residency Programs at Eastman Dental Center Receive Full Accreditation – April 12, 2005

Dentistry News Releases 2004

Jack G. Caton to be recognized as a national leader by the American Academy of Periodontology – September 16, 2004

Interim Clinical Director of Outreach Programs Named – September 13, 2004

New Chair of Dentistry’s Division of Orthodontics and Craniofacial Orthopedics Appointed – September 13, 2004

Finding the Hole in the Defenses of Cavity-Creating Microbes – June 25, 2004

IADR/Unilever Hatton Award Winner – May/2004

Pediatric Craniofacial Team Provides Comprehensive Care – Spring 2004

Student takes 2nd place in prestigious Hatton Award Competition</a- April 2004

Community Dentistry dental assistant returns home from active duty</a- April/2004
Eastman Dental Center awarded funds to increase the number of underrepresented minorities in academic dentistry 3/31/2004

Orthodontist Given Alumni Affairs Award – February/2004

Dr. Todd Thierer Appointed Medical Director For Eastman Dental Center – February/2004

IADR/Unilever Hatton Award Winner – May 03, 2004

Dental Care: From Urgent to Routine – May 03, 2004

Eastman Dental Center Awarded ADEA Funds – May 03, 2004

Keeping America Running – May 03, 2004

Solving the Mystery of the Dancer Mice, and Cleft Lip Too – April 29, 2004

Dentistry News Releases 2003

Dentistry Hosts American Dental Association (ADA) Student Research Conference  – 7/2003

Local American Association of Dental Research (AADR) Research Awards Given – 7/2003