Dr Lee\'s oresentation to Fresno County Dep\'t of Health\'s Oral Health Advisory Committee quarterly meeting. Audience: health educators, careproviders from various public and private entites in Fresno County

1. MOHACMOHAC
PRESENTATIONPRESENTATION
OCT.19, 2007OCT.19, 2007
Treva D. Lee, DDS, MAGDTreva D. Lee, DDS, MAGD

3. Does our past foreshadow our future?

4. Mobile dentistry then... Mobile dentistry now...

5. Real-world, real-time, real-
compensation (ie, non-
specialist)
• Simple procedures
• rewarding
• Fast, 6-handed
dentistry
• reasonable
durability
• compromised
control issues
• Non-urgent care , 6
weeks to 3 months
for appt w/specialist
• Psychological
damage throughout
lifetime of patient
• Fewer OR time slots
available

6. Distraction, crescent booster seat, MagicFil sparkle
compomer

7. Amalgam in Post. #S, Composite in Ant. #R

8. PQ amalgam as liner, Ag better in less than ideal conditions

9. K.I.S.S., t-bands, tell-show-do

10. 5yr old boy vs 5 yr old girl

11. Treasure box!
• Speak and treat
kids as if they
were grownup
(corollary is: many
adults want to be
approached as if
they were kids)

12. DIAGNOdent
- Laser
Caries
Detection Aid
Accurate, reliable caries detection aid
More and more patients place value on healthy and
attractive teeth. In order to maintain them, the
earliest possible care is essential. DIAGNOdent
aids in the detections of caries. Even very small
lesions are detected at the earliest stage, enabling
us to protect and preserve the tooth substance.

13. If you cannot detect the disease, how can you
treat it? Dentists often experience anxiety when
attempting to diagnose the phenomenon known as
hidden caries. A suspicious-looking tooth presents
a treatment dilemma for dentists. Should the
tooth be opened up? What if no caries is found?
Should the tooth just be watched, or does that
give caries more time to destroy the tooth's
surface?
A changing caries model: due to fluoridation,
caries has gone "underground". While helping to
improve the oral health of many Americans,
fluoridation has resulted in harder tooth
enamel. Incipient caries lesions that once began
on the tooth's surface have now migrated below
the surface.

14. * Permits use of minimally invasive treatments without unnecessary
preparation - ideal adjunct to air abrasion and micro rotary
instruments.
* For the first time, allows the quantification of caries activity
over time with a precise and reliable measurement.
* Reproducible results permit checking, stabilization and
documentation of caries.
*Ideal device for the hygienist to detect suspicious areas needing
further examination.
* Is conservative by avoiding "exploratory" excavation of suspect
teeth.
*Extremely accurate diagnostic aid. Proven to be over 90%
accurate.
* Early detection of pathological changes that are undiagnosed by
conventional examination methods (e.g. intial lesions,
demineralization and changes in the enamel, fissure caries).
* No scratching probe: simple, fast and painless examination.
*Increases operator and patient confidence about treatment
decisions due to accurate visual and acoustic representation of
measured values.
* No x-ray exposure. High level of patient acceptance and
satisfaction

15. Over 90% accurate
Proportion of "correct diagnoses" using various diagnostic
methods (in the case of seemingly intact occlusal surfaces).
In a study conducted by Dr. Lussi of Berne University, Switzerland,
general practitioners correctly diagnosed hidden fissure areas by
visual inspection in only 57% of all cases. The same group achieved
an impressive success rate of 90% with the DIAGNOdent. In fact,
DIAGNOdent was far more accurate than any other method in the
study including bitewing X-rays.

16. Altered tooth substances and bacteria fluoresce when they are
exposed to a specific wavelength of light.
The DIAGNOdent operates at a wavelength of 655 nm. At this
specific wavelength, clean healthy tooth structure exhibits little or
no fluorescence, resulting in very low scale readings on the display.
However, carious tooth structure will exhibit fluorescence,
proportionate to the degree of caries, resulting in elevated scale
readings on the display of the DIAGNOdent.
An audio signal allows the operator to hear changes in the scale
values. This enables the focus to be on the patient, not solely on the
device

17. Suggested Retail Price:
$2600.00 KaVo DIAGNOdent 2095 (item number 574 0500) includes:
- Battery pack
- 5 AA batteries
- Handpiece tubing
- Handpiece gripping sleeve
- Light-tip cassette
- 2 Light tips A
- 1 Light tip B
- Operating instructions

18. Sponsored Links
Fluoride Is Poison
There are better ways to take care
Of your teeth. Find out how.
www.douglassreport.com/fluoride
Sponsored Links
Help STOP Fluoridation
900 Professionals Say it Should End
Sign online petition to Congress!
www.FluorideAction.org
“Junk science” on the Internet

19. Fluoridex Daily Renewal 0.63% Stannous Fluoride
Rinse is ideal for post-periodontal surgery, perio
maintenance, and patients with brushing sensitivity.
This rinse may be used daily or in an irrigator to help
remineralize the teeth and assist with treating root
surface sensitivity. Each bottle includes a convenient
metered pump and mixing cup (10-fl.oz).
Fluoridex Daily Renewal 0.63% Stannous
Fluoride Rinse 10-oz bot$25.00
(online retailer price, my patients pay $12.00)

20. The ONLY varnish formulated to deliver
ACP (Amorphous Calcium Phosphate)
Deposits ACP (Amorphous Calcium
Phosphate) ACP stimulates
remineralization of tooth enamel
ACP prevents the loss of enamel
Desensitizes Dentin
Desensitizes by depositing ACP and
fluoride
into the tubules
ACP crystallizes and forms apatite -
tooth-like mineral
Delivers More Fluoride
Provides 3x more available fluoride to all
tooth surfaces
Delivers 2x more fluoride uptake into
the enamel 8

21. Enamel Pro Varnish .40mL Straw/Cream 35/Bx
Item Code: 3787569
Manufacturer: Premier Dental
Category: Preventives
Subcategory: Fluoride Office - Varnish
Unit of MeasureInventoryPriceYour PriceQtyLast
PurchasedBXAvailable1 @ $57.99
1 @ $54.99
BX
(+ tax&shipping, approximately $1.80/application)

22. Teeth need calcium, phosphate and fluoride. Healthy saliva contains
these minerals, and in conjunction with certain salivary proteins is able to
deliver bio-available calcium and phosphate to the tooth surface during
the demineralization/remineralization process. Calcium and phosphate are
known to help:
Strengthen tooth enamel
Reduce sensitivity
Buffer plaque acid

23. Features and Benefits:
RECALDENT™ (CPP-ACP) – Bio-available
Calcium and Phosphate:
Contains RECALDENT™ (CPP-ACP). Casein Phosphopeptide (CPP) are natural
occurring molecules which are able to bind calcium and phosphate ions and
stabilize Amorphous Calcium Phosphate (ACP)
RECALDENT™ (CPP-ACP) is a special milk-derived protein that can help replace
lost minerals in teeth, make them stronger and helps protect them from decay
and erosion.
Adheres easily to soft tissue, pellicle, plaque and even hydroxyapatite. Reacts
similar to the mineral/statherin relation in saliva supplying bio-available calcium
and phosphate required for remineralization to take place.
Under acidic conditions, RECALDENT™ (CPP-ACP) releases calcium and
phosphate ions into tooth enamel
Supplies calcium and phosphate needed for patients with poor saliva flow. This
situation can be further augmented by elevating the level of fluoride.

24. Prophy cup application: Apply generous layer of
MI Paste as a final polishing after routine
prophylaxis. Patient does not need to rinse away.
Custom tray application: Extrude a generous
layer to tray and position in patients mouth for 3
minutes.
MI Paste is digestable if swallowed.
Products containing RECALDENT™ (CPP-ACP)
should not be consumed by people with milk
protein allergies. RECALDENT™ (CPP-ACP) is
digestible by people with lactose intolerance.
After initial treatment, the tube of MI Paste can
be used for professionally supervised at-home
follow-up

25. MI Paste Plus Assortment 40gm 10/Bx
Item Code: 3338426
Manufacturer: GC America, Inc.
Category: Preventives
Subcategory: Miscellaneous
Unit of
MeasureInventoryPriceYour
PriceQtyLast Purchased
BXAvailable1 @ $130.99
1 @ $119.99
BX
(I charge patient $14.00/box)

27. www.drtrevalee.com