Dr. Steinberg’s Blog

Paradigm Shifts In the Understanding and Management of Dental Caries Using Evidence-Based Dentistry.

General dentists are the specialists responsible for the understanding and management of dental caries. Dental specialists, medical professionals and of course patients depend on your expertise. As such, you must update your paradigm of dental caries constantly. In part one, the state-of-the-art in our understanding of dental caries will be covered. Modern management requires an understanding that caries is a chronic infectious disease process affecting tooth mineral in a patient. The lesion is the result of that process on an individual tooth. Management of the disease process is far more than treating cavitations. Evidence-based research has taught us that caries is a reversible process caused by several risk factors and specific bacteria in biofilm. Learn how to diagnose and treatment plan using a medical approach to this disease process. Also learn about CAMBRA – caries management by risk assessment – as well as the new technologies and chemotherapeutics, such as remineralization, available for the modern management of this disease.

Part two is entitled “How do you know?” As new materials and techniques are introduced, how is a dentist to know their safety and efficacy? Are new materials and techniques better, the same or worse than what we’ve used in the past? Where do we get the relevant information? How do we evaluate the information? Do we simply trust the experts? And who decides who is an expert? These questions apply in particular to the modern management of dental caries. Learn how our questions can be answered through the evidence-based dentistry triad of 1) gathering the best evidence from studies, 2) incorporating the patient’s treatment needs and preferences and 3) the clinical expertise of the individual dental professional who must integrate all the information into a management plan.

You will learn:
• The latest model for understanding and managing dental caries.
• How to detect and classify lesions on teeth.
• How to diagnose today and assess the future risk of dental caries disease.
• How to use that information to formulate a treatment plan.
• The three parts of a modern caries treatment plan.
• The role of CAMBRA.
• Remineralization therapies.
• The use of medications for therapy and prevention.
• The concepts of evidence-based dentistry.
• How to use evidence-based dentistry for improved understanding and management of dental caries.
• How to use evidence-based dentistry elsewhere in your practice.
• How to increase patient compliance.
• How to grow your practice using this information.
• How to grow professionally and personally using this information.

A Paradigm Shift in the Modern Management of Dental Caries

Many dentists are using an outdated paradigm in the treatment of dental caries. Modern management requires an understanding that caries is an infectious disease process in a patient. A lesion is the result of that process on an individual tooth. Management of the disease process is far more than treating cavitations. Evidenced based research has taught us that caries is a reversible process caused by several risk factors and specific bacteria in biofilm. Learn how to diagnose and treatment plan using a medical approach to this infectious disease. Also learn about CAMBRA- caries management by risk assessment as well as the new technologies and chemotherapeutics, such as remineralization, available for the modern management of this disease.

Seven Key Points that a Cosmetic Dentist Must Know about Dental Caries Management

We live in an age of incredible cosmetic dental accomplishment. Cosmetic dentists are creating artistic masterpieces in the mouths of their patients. However, for the high risk caries patient, this may be the equivalent of a Rembrandt or Monet painting being placed on a crumbling canvas. In cases where so much time and money has been invested by both the dentist and the patient and where legal issues may arise, one must try to avoid such an outcome. This course will empower the cosmetic dentist in recognizing and managing the high risk dental caries patient. Modern management of dental caries requires new tools of diagnosis, risk assessment and treatment planning. Cosmetic success can only be achieved on a strong foundation. Understanding the dental caries disease process and its management by the dental team is critical to long term cosmetic success.

Clinical Trends in the Diagnosis and Treatment of Dental Caries.

There are new trends in the diagnosis and treatment of dental caries. Excellent clinical results depend on a clear understanding of the dental caries disease process. Learn how to use that understanding to diagnose and treatment plan with a medical approach. A protocol based on the latest information from clinical dentistry and research will be presented. Can we predictably remineralize diseased teeth? If so what techniques and materials should we use? What new technologies are useful and practical? What are the roles of fluoride, chlorhexidine rinse, xylitol gum and calcium containing products? Learn the answer to these questions as well as other practical clinical information that can be used immediately.

How Do You Know? Modern Caries Management using Evidence-based Dentistry.

As new materials and techniques are introduced, how is a dentist to know their safety and efficacy? Are new materials and techniques better, the same, or worse than what we have used in the past? Where do we get the relevant information? How do we evaluate that information? Do we simply just trust the experts? And who decides who is an expert? These questions apply in particular to the modern management of dental caries. There is a new paradigm of caries as a reversible disease process caused by several risk factors and specific bacteria in tooth biofilm. That paradigm will be assessed through the tool of evidence-based dentistry. Learn how our questions can be answered through the evidence-based dentistry triad of 1) gathering the best evidence from studies, 2) incorporating the patient’s treatment needs and preferences, and 3) the clinical expertise of the individual dental professional who integrates all the information into a management plan.

Remineralization Therapies for Early Caries Lesions

The lesion of dental caries in its early stages can be remineralized. Learn how to detect pre-cavitated caries lesions suitable for remineralization. Current and potential future detection devices and techniques will be reviewed. Hear about the many medications that can be used to remineralize caries lesions. We will discuss the roles of fluoride, chlorhexidine rinse, xylitol gum and calcium containing products such as amorphous calcium phosphate, MI paste, NovaMin and others. Valuable information will be given that can be used immediately in clinical practice.

How Do You Know? The Evidence-Based Dental Practice

As new materials and techniques are introduced, how is a dentist to know their safety and efficacy? Are new materials and techniques better, the same, or worse than what we have used in the past? Where do we get the relevant information? How do we evaluate that information? Do we simply just trust the experts? And who decides who is an expert? The best answer that we have to these questions is Evidence-based Dentistry. The ADA defines evidence-based dentistry as: an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical condition in history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences. Learn how our clinical questions can be answered through the evidence-based dentistry triad.

What Every Dentist Needs to Know about High Risk Dental Caries Patients

20% of the individuals in America get 60 to 80% of the caries lesions. These individuals are high risk patients. To ensure success in the treatment of these high risk individuals new concepts and clinical modalities must be applied. New concepts include using a medical approach to diagnose and treatment plan high risk patients. Caries can be understood as a reversible disease process caused by risk factors and specific bacteria in tooth biofilm. New detection devices and techniques are available to identify pre-cavitated caries lesions. These lesions can be remineralized. Remineralization techniques will be reviewed. A clinical protocol as well as other practical clinical information that can be used immediately will be presented.