Made in China
May 29, 2012
I just returned from my semi-annual journey to my dental lab in Georgia where I meet with a group of dentists who share both the laboratory we use and the passion for excellence in what we do. The topic of dental restorations made overseas came up. Mr. Terry Fohey, certified dental technician and owner of NuCraft Dental Arts, one of the finest dental laboratories in the country, believes that a dental patient should have the right to know where the materials are coming from that are being put in their mouth.
China and other countries can claim to use specific materials, but there are no regulations in place to verify the information. There are also no regulations that allow a dental patient the right to know where the materials came from that are being placed in his/her mouth.
With the help of a State Senator from Georgia, Mr. Fohey is proposing legislation requiring dental laboratories to disclose to the dentist the material contents and point of origin of every dental restoration. It would also require the dentist to disclose the information to the patient should the patient ask. Would it make a difference to you whether or not your crown was being made in the United States or not?
Why are some dentists and dental laboratories farming out dental restorations overseas? Like everything else in the world, money is the reason. I get advertisements in the mail daily of dental laboratories able to make crowns for ridiculously low prices. It apparently sounds enticing to some practitioners.
Wonder why some dentist’s fees are higher or lower than others for this service? There are actually many factors that go into the creation of a fee for a procedure that requires a laboratory expense. The patient never sees the laboratory expense in most cases because it is built into the total fee. Clinical experience, clinical skill, office overhead, time required, and nature of the practice are all things that go into the creation of a fee.
The cost of the laboratory procedures also greatly affects the cost for the dental procedure. Let’s take crowns for example. I have seen laboratory fees advertised as low as $39 per crown and know of other dental labs whose fee is a few hundred dollars per tooth. Some patients would accept a lower quality product going into their mouth for a lower cost and others would not.
There are even machines you can buy that can fabricate crowns while you wait. There are many choices. It is basically up to the dentist to decide what he/she feels is in the best interest of the patient based on knowledge and skill.
In my experience, laboratories that cost more tend to make a better product. That better product which gets put in your mouth is a direct reflection on the dentist placing it. Excellent lab work, however, does not make up for less than perfect clinical skills. I have been in practice for 16 years. It took me a good 7 years to find a laboratory that meshed with what I try to accomplish for my patients…..and believe me, it was painful getting there.
We live in an ever-changing world. I try to buy American as often as possible, but realize that it is not always feasible. Mr. Fohey summed it up this way, “This bill is simply about disclosure. It does not restrict anyone from importing dentistry. Instead, it just makes us all play by the same rules.”
Recent Studies You Should Be Aware Of
May 22, 2012
I have preached for years, based on the information available, that there was a direct relationship between gum disease, heart disease, stroke and other health issues. This morning I received an email from the American Dental Association (ADA) about the newest report on this subject.
A report published recently in Circulation, the journal of the American Heart Association (AHA), states that current scientific evidence does not establish a direct cause and effect relationship between gum disease and heart disease or stroke. Additionally, the evidence does not establish that gum disease increases the rate of heart disease or stroke.
The report was developed by an AHA expert committee comprised of dentists, cardiologists and infectious disease specialists. The ADA’s Council on Scientific Affairs appointed a representative to the committee that examined 537 peer-reviewed studies on the subject in order to develop the report. The CSA then reviewed the report and agreed with its conclusions.
The report acknowledges the value of good oral hygiene to maintain good overall health but noted that current scientific data does not indicate whether regular brushing and flossing or treatment of gum disease can decrease the incidence of atherosclerosis, which is the narrowing of the arteries that can lead to heart attacks and stroke.
Last week, in typical media-slanted coverage, was a study published in Cancer, a scientific journal of the American Cancer Society, associating yearly or more frequent dental X-rays with an increased risk of developing meningioma, the most commonly diagnosed brain tumor. This type of tumor is usually not malignant. The study has received widespread media coverage, and a number of the stories cite the ADA’s dental x-ray recommendations that help dentists determine how to keep radiation exposure as low as reasonably achievable.
Study participants averaged 57 years old and were asked to remember how many x-rays they received as kids before age 10. That’s a stretch for believability – remembering details from 47 or more years ago? That long ago, x-ray technology was vastly different from today. When I was a kid, I probably got 100 times more harmful radiation from x-rays than kids (or adults) today.
Statistics show about 5,000 of this type tumor diagnosed each year in the U.S. In a country of over 310 million people, 5,000 is less than .001%. And, there are almost certainly many other causes other than dental x-rays. Granted, every brain tumor is serious, particularly to the person with the tumor and his/her loved ones, and the topic must be approached appropriately.
So, what do these two recent studies mean to you as patients and “us” as dentists? To be honest, not much for most of us. The fact remains that if you have untreated or uncontrolled gum disease, which has a strong genetic component, you will lose your teeth but apparently won’t die from it. And, if you don’t go to the dentist regularly and/or refuse dental x-rays at appropriate intervals, you put yourself and your dentist at significant risk.
Studies like these are important for the progression in any area of our society. However, it is important to look at the big picture. Teeth are important and good dental health greatly increases the quality of life. Just ask the patient I saw last Sunday for an emergency extraction after days of excruciating pain having not been to a dentist in a few years.
Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@dentalhealthforlife.com. You can view all previously written columns at www.dentalhealthforlife.com.
