Canadian Man Accused Of Unauthorized Horse Dentistry: ‘A Display of Lawless Bravado’

A Canadian man is facing a lifetime ban on practicing veterinary medicine after accusations he’s been performing unauthorized horse dentistry.

The Manitoba Veterinary Medical Association (MVMA) is seeking a permanent injunction against Kelvin Brent Asham, accused of treating horses—including giving one horse a sedative—without veterinary certification.

An investigator described Asham’s actions as “a display of lawless bravado,” according to court documents.

The MVMA says it’s been trying to stop Asham for the past three years: It first became aware of his activities in 2015, when a complaint was filed about a 16-year-old gelding he had treated. Asham sedated the horse, filed down its teeth—a process known as “floating”—pulled one tooth and tried to extract another.

horse teeth dentist
The sharp edges of horses’ teeth occasionally needs to be filed down to save the horse from pain when eating or holding a bit in its mouth. The term “floating” comes from the file used in the process, known as a “float.”
Anna Elizabeth/Getty

Leon Flannigan, an animal protection officer in Manitoba, investigated the claims and determined the horse had suffered “irreparable damage.” In an affidavit, Flannigan said he’d met with Asham in 2016 at a Tim Horton’s donut shop in Selkirk. Asham allegedly told Flannigan he’d been floating horse teeth since 1996 and had performed the procedure on four other horses owned by the same person as the gelding.

Asham also told Flannigan that most vets float teeth improperly, and that he had different tools than vets use. “Off the record, I do thousands of horses,” Asham allegedly told Flannigan. “I do a good job. I am willing to fight this in court.”

This incident caused the MVMA to send Asham a cease-and-desist letter in 2017, as he is not a licensed veterinarian.

But last year, the MVMA found out that Asham was still working as a equine dentist and was recommended on Facebook. The MVMA hired private investigator Russ Waugh to go undercover and try to hire Asham.

According to Waugh’s affidavit, Asham told him the horse Waugh brought in could be treated for $200 CAD (about $150), the average price for floating teeth. After the investigation, the MVMA filed suit against Asham, asking a judge to ban Asham from acting as a vet.

“By engaging in the unauthorized practice of veterinary medicine, the respondent effectively declares himself to be outside the law,” writes Robert Dawson, an attorney for the association.

This isn’t Asham’s first run-in with the law: In December 2001, the then-37-year-old was arrested after admitting to carrying 10 one-kilogram bricks of cocaine in his truck. Asham and Barry Vaughan Hancock, who was also in the truck when it was pulled over, were each charged with possession of cocaine for the purposes of trafficking.

At the time, Hancock was an equine dentist.

This content was originally published here.

Important Studies on Opioid Prescribing: Implications for Dentistry – TeethRemoval.com

Recently on this site several articles have appeared discussing opioid prescribing after wisdom teeth removal see for example the posts Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal? and Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse. Very recently several interesting studies regarding opioid prescribing have published.

The first study is titled “Trends in Opioid Prescribing for Adolescents and Young Adults in Ambulatory Care Settings” written by Hudgins et al. appearing in Pediatrics in June 2019 (vol.143, no. 6, e20181578). The article explored opioid prescribing for adolescents (ages 13 to 17) and young adults (ages 18 to 22) receiving care in emergency departments and outpatient clinics. Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) over the time period from January 1, 2005, to December 31, 2015 was used. It was found the most common conditions associated with opioid prescribing among adolescents visiting emergency departments was dental disorders (59.7%), clavicle fractures (47%) and ankle fractures (38.1%) and among young adults visiting emergency departments was dental disorders (57.9%), low back pain (38%), and neck sprain (34.8%). Thus in both cases when someone ages 13 to 22 goes to an emergency department because of a dental disorder they are nearly 60% likely to leave with an opioid prescription. Studies suggest that adolescents and young adults are the most likely to misuse and abuse opioid medications. Thus the authors imply it is possible that many of these opioids being prescribed for dental disorders are being used for non medical use.

An accompanying commentatory of the article by Hudgins also provides additional insights into the article titled “Opioids and the Urgent Need to Focus on the Health Care of Young Adults” written by Callahan also appearing in Pediatrics in June 2019 (vol. 143, no. 6, e20190835). Callahan says that research looking at young adults is often not available as they often get grouped into adolescents in studies. Callahan states:

“Efforts to improve research and health care for young adults are further hindered by (1) the lack of a consensus definition of young adulthood, (2) the false perception that young adults are healthy, (3) fragmented health insurance coverage during young adulthood, and (4) little organized advocacy on behalf of young adults.”

Callahan thus calls for more research tailored to young adults. Young adults are of course a target demographic for wisdom teeth surgery.

The second study is titled “Comparison of Opioid Prescribing by Dentists in the United States and England” written by Suda et al. appearing in JAMA Network Open in 2019 (vol. 2, no. 5,e194303). The article explored opioid prescribing differences by dentists in the United States of America and England. The authors looked at data from IQVIA LRx in the U.S. and the NHS Digital Prescription Cost Analysis in England. The authors found in 2016 dentists prescribed more than 11,440,198 opioid prescriptions in the U.S. and 28,082 opioid prescriptions in England. Dental prescriptions for opioids were 37 times greater in the US than in England. In the U.S. various opioids were prescribed including hydrocodone-based opioids (62.3% of time), codeine (23.2% of the time), oxycodone (9.1% of the time), and tramadol (4.8% of the time) whereas in England only the codeine derivative dihydrocodeine was prescribed. The authors state:

“The significantly higher opioid prescribing occurs despite similar patterns of receiving dental care by children and adults, no difference in oral health quality indicators, including untreated dental caries and edentulousness, and no evidence of significant differences in patterns of dental disease or treatment between the 2 countries.”

The authors in the article by Suda point out that the patients included in the study from England were limited to receiving medications from the U.K.’s National Health Service. However they feel that their study shows that U.S. dentists prescribe too many opioids and this practice is contributing to the opioid epidemic in the U.S.

In both studies above it seems that the authors feel that patients in the U.S. are receiving too many opioids for dental related issues and that other medications that can provide pain relief should be given. When opioids are given they should be prescribed in the shortest duration necessary to deal with the expected amount of pain the patient is dealing with. However, a limitation of both studies is the authors were unable to assess the appropriateness of the opioid prescriptions given.

This content was originally published here.

Updated Sedation Guidelines in Dentistry for Children – TeethRemoval.com

Recently new guidelines have been issued regarding the use of sedation for dental procedures performed on children. In the past on this site some scrutiny has been placed on sedation provided to children during dental procedures because of many deaths that have occurred, see for example What to Ask the Dentist Before Children Have Sedation and Pediatric Dental Death in Cambridge, Ontario, Canada Spurs Comments on Dental Anesthesia. In the June 2019 edition (vol. 143, no. 6) of Pediatrics in an article titled Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures written by Coté and Wilson updated guidelines for the use of sedation in dentistry is provided. These guidelines were updated for the American Academy of Pediatric Dentistry (AAPD) and American Academy of Pediatrics (AAP) for the first time in three years. These recommendations apply to all of those whom are providing deep sedation or general anesthesia in an office environment to children even if the state board does not mandate such a recommendation.

What has changed in these recommendations has been intensely contested when it comes to giving sedation to those undergoing wisdom teeth removal. The guidelines in the 2019 edition of Pediatrics call for two trained personnel to be present when deep sedation or general anesthesia is given to a child at a dental facility. The previous guidelines called for one trained person to be present when deep sedation or general anesthesia is given to a child at a dental facility. Specifically the June 2019 guidelines state:

“During deep sedation and/or general anesthesia of a pediatric patient in a dental facility, there must be at least 2 individuals present with the patient throughout the procedure. These 2 individuals must have appropriate training and up-to-date certification in patient rescue… including drug administration and PALS [ pediatric advanced life support] or Advanced Pediatric Life Support (APLS). One of these 2 must be an independent observer who is independent of performing or assisting with the dental procedure. This individual’s sole responsibility is to administer drugs and constantly observe the patient’s vital signs, depth of sedation, airway patency, and adequacy of ventilation.”

The guidelines call that the independent observer must one of: a certified registered nurse anesthetist, a physician anesthesiologist, an oral surgeon, or a dentist anesthesiologist. The independent observer must be trained in PALS or APLS and capable of managing any airway, ventilatory, or cardiovascular emergency resulting from deep sedation or general anesthesia given to the child. The person performing the dental procedure must be trained in PALS or APLS and be able to provide assistance to the independent observer if a child experiences any adverse events while sedated.

It is reported that the guidelines developed rely mostly on medical data because data for sedation in dental offices is not as readily available. Steps are being taken to incorporate more data regarding dental sedation into new guidelines. The reason for the updated guidelines is to increase safety for children having dental procedures in dental offices.

It is not clear how the American Association of Oral and Maxillofacial Surgeons may react to these June 2019 guidelines. They have long argued that their care model of having an oral and maxillofacial surgeon administer the sedation and perform the dental surgery is safe and cost effective (as seen in a recent May 2019 tweet below). Even so other physician organizations in the past have questioned their care model and it has long been suggested on this site that it may be safer to have oral surgery performed at a hospital if you are receiving sedation or anesthesia, see for example Anesthesia in the Oral and Maxillofacial Surgeons Office.

Oral and maxillofacial surgery anesthesia teams have the extensive training and experience needed to assist patients with pain and anxiety during procedures. https://t.co/sN9C5LCVHo #oralsurgery #myoms pic.twitter.com/fDhR3Jiz2d

— AAOMS (@aaoms)

Additional Source:

This content was originally published here.

Dental House NYC: Dentistry with a Pampering Spa Twist – Beauty News NYC – The First Online Beauty Magazine

Start 2019 with a dental re-boot. There’s nothing typical about the newly opened Dental House apart from its efficiency and professionalism. Located on the NE corner of 13th Street and Seventh Avenue in Greenwich Village, it’s an art-filled, airy, modern neighborhood dental practice – where things are carried out with more thought and pampering than your typical dental practice. For example, your lips are slathered with a softening, aromatic Rose Salve for your comfort, you’ll savor dark chocolate treats, sunglasses to cut any machine glare, and glasses of water to stay hydrated. Here you can enjoy all of the typical dental office treatments: x-rays, cleanings, whitening treatments, and more.

If you’ve ever hoped for a dental visit that would be soothing and reassuring while offering a full suite of typical services, then Dental House is indeed your dream dental office. Dr. Sonya Krasilnikov is well-experienced, charming, and able to thoroughly explain every aspect of your necessary treatments. You may have just found your favorite new dentist! Her partner, Dr. Irina Sinensky, is equally awesome.

Check out the Dental House website, and schedule and appointment to check off those health-oriented New Year’s resolutions:

You’ll leave Dental House with a Theo Dark Chocolate bar. Dark chocolate is a healthy snack option for dental care because cocoa beans contain beneficial ingredients that disrupt plaque formation and strengthen enamel. The less sugar in the chocolate, the better the chocolate is for you. Enjoy!

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This content was originally published here.

Outcomes Data Registry for Dentistry – TeethRemoval.com

Using large amounts of data from many different dentists or surgeons is a way to improve the quality of healthcare. From such clinical data registries in healthcare
many things can be gleaned regarding information about individual surgeries or medical devices. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has recently launched OMS Quality Outcomes Registry or OMSQOR for short which is discussed on pages 7-12 of the March/April 2019 issue of AAOMS Today. The groundwork for OMSQOR actually began in 2014 and OMSQOR officially launched in January 2019. The way OMSQOR works is that treatment data from all members who participate will be collected in a national registry that will be used to help improve the quality of care and patient outcomes. Such quality data will allow for tracking surgical outcomes, complications, and possible gaps in treatment. OMSQOR will even allow an individual surgeon to compare their patients to all patients in the database to identify areas in their practice they may be lacking and improvement is needed. AAOMS is encouraging all of their members to sign up and participate.

The data registry will be used to help AAOMS be able to better advocate on behalf of oral and maxillofacial surgeons along with conduct additional research to improve outcomes. Practice patterns across the entire specialty can be tracked. This can allow for better reimbursement for services that is fair where insurance companies may be challenging them. This can also allow for better data showing how often an anesthesia death occurs by oral and maxillofacial surgeons. This is important to them because many have challenged their delivery model of having the surgeon both perform surgery and deliver anesthesia which is not how surgeries are conducted in other specialties. The data registry can allow for the frequency of particular complications after particular surgeries to be identified. Of particular interest is identifying the frequency of nerve injuries after wisdom teeth surgery. The data registry can also be used to explore medical prescription prescribing habits which is of particular interest with recent studies demonstrating possible over prescribing of opioids which are then diverted to non medical use. According to the AAOMS Today article:

“Often, anesthesia advocacy stalls because AAOMS does not know how many anesthetics OMSs safely and routinely use. With OMSQOR, relevant aggregate data can be collected and safety statistics shared with federal and state agencies as well as insurance companies.”

Currently the safety of oral and maxillofacial surgeons delivery anesthesia is measured by several morbidity and mortality studies that have been conducted over time see for exaxmple http://www.teethremoval.com/mortality_rates_in_dentistry.html along with anecdotal reports and hearing about patient death or serious injury from media reports. Included with OMSQOR, is a Dental Anesthesia Incident Reporting System (DAIRS) which is an anonymous self-reporting system used to gather and analyze
information about dental anesthesia incidents. For example if an equipment fails or a cardiac event occurs in a patient a surgeon could report this anonymously using DAIRS. All dental dental anesthesia providers are being encouraged to report to DAIRS in order to help improve patient outcomes.

Even with the advantages of OMSQOR it is true that some members may be hesitant to want to use the system. This is because it can potentially be a significant time burden involved with the initial set-up to import all the data and surgeons may frankly just not like everyone else knowing intimate details about their practice. In addition their may be concerns with patient privacy. Both patient information and surgeon information will however be de-identified in the data registry so these concerns should not be subdued. Even so it may be possible to re-identify de-identified data. For example if there is a rare complication or death that occurs and is then picked up by the news media it may be possible to piece together who the patient and doctor is. Even with the limitations it seems that if many oral and maxillofacial surgeons and dental anesthesia providers use both OMSQOR and DAIRS then patient outcomes for dental procedures including wisdom teeth surgery may improve in the future.

This content was originally published here.

The Oral-Systemic Connection & Our Broken Healthcare System – International Academy of Biological Dentistry and Medicine

Say Ahh, the world’s first documentary on oral health, takes a sobering look at the state of our national healthcare system. Despite being one of the wealthiest nations in the world, home to some of the most advanced medicine and technology, America is suffering from a drastic decline in the overall health of its citizens. …

This content was originally published here.

UNHCR - Turkey scholarship lets star Syrian student pursue dentistry dream

Since she arrived in Turkey six years ago, Syrian refugee Sidra has mastered a new language, worked in a factory to support her family and graduated top of her year in high school.

Her breakthrough came when she won a university scholarship. She is now in her second year of a dentistry degree, and fulfilling a life-long dream

“I am very passionate about education,” said the 21-year-old, who fled war-ravaged Aleppo with her family in 2013. “My dream was to go to university, and I studied very hard to achieve this dream.”

Her achievement reflects a single-minded determination to continue her education, even when it seemed she might not get the chance. She missed her final year of high school in Aleppo when fighting forced the closure of local schools, and when she first arrived in Turkey, she lacked the paperwork needed to enroll.

“The day I went back to school was beautiful.”

Unable to study, she took a full-time job packaging goods in a medical supplies factory while teaching herself Turkish in her time off from books and YouTube videos. A year later, when she secured the refugee documentation needed to resume her education, she vowed to make the most of it.

“The day I went back to school was beautiful,” she said. “The worst thing about war is that it destroys children’s futures,” she continued. “If children don’t continue their education, they won’t be able to give back to society.”

After graduating from high school top of her class with an overall mark of 98 per cent, Sidra then went one better to score 99 per cent in her university entrance exams. The results helped her to secure a vital scholarship from the Presidency for Turks Abroad and Related Communities (YTB).

While tuition fees at Turkish state universities have been waived for Syrian students, the scholarship provides Sidra with monthly support, enabling her to concentrate on her studies. Without this support she says she would not have been able to study her preferred subject of dentistry due to the extra cost of buying equipment such as cosmetic teeth to practice her skills.

Sidra practices her dentistry skills at home while her younger sister Isra looks on. © UNHCR/Diego Ibarra Sánchez
Sidra attends a practical lesson at Istanbul University, where she is studying dentistry. © UNHCR/Diego Ibarra Sánchez
Sidra stands outside her home in Canda Sok on the outskirts of Istanbul. © UNHCR/Diego Ibarra Sánchez
Sidra spends time with a friend on the historical Galata Bridge in Istanbul. © UNHCR/Diego Ibarra Sánchez
Once a week, Sidra teaches classical Arabic to Malak, an 8-year-old Turkish girl, at her home in Istanbul. © UNHCR/Diego Ibarra Sánchez

“Without the scholarship, I would have had to choose a different major, different to dentistry, and to work to cover my university expenses,” she explained.

Sidra is one of around 33,000 Syrian refugee students currently attending university in Turkey. The country is host to 3.68 million registered Syrian refugees, making it the largest refugee hosting country in the world.

Since the beginning of the Syria crisis, YTB has provided 5,341 scholarships to Syrian university students, while a further 2,284 have received scholarships from humanitarian partners. This includes more than 820 scholarships provided by UNHCR – the UN Refugee Agency – under its DAFI programme.

Access to education is crucial to the self-reliance of refugees. It is also central to the development of the communities that have welcomed them, and the prosperity of their own countries once conditions are in place to allow them to return home.

Enrolment rates in education among refugees currently lag far behind the global average, and the gap increases with age. At secondary school level, only 24 per cent of refugee children are currently enrolled compared with 84 per cent of children globally, with the figure dropping to just 3 per cent in higher education compared with a worldwide average of 37 per cent.

In Turkey, this average has been raised to close to 6 per cent thanks to the priority attached to education, including higher education for refugees.

Efforts to boost access and funding for refugees in quality education will be one of the topics of discussion at the Global Refugee Forum, a high-level event to be held in Geneva from 17-18 December.

Turkey is a co-convenor of the event, which will bring together governments, international organizations, local authorities, civil society, the private sector, host community members and refugees themselves. The event will look at ways of easing the burden of hosting refugees on local communities, boosting refugee self-help and reliance, and increasing opportunities for resettlement.

“Successful people can support the country they’re living in.”

Sidra is convinced that education holds the key to her own future success, and is determined to live up to the nickname she has earned among her fellow students.

“People call me ‘çalışkan kız’ which means: ‘the girl who studies a lot’,” she explained. “With education we can fight war, unemployment and illiteracy. With education we can reach all our goals in life.”

“Successful people can support the country they’re living in,” she continued. “Turkey has given me a lot of facilities, and it honors me that one day I can give back to its people and be an active member [of society], to work and practice dentistry with their support. I take pride in this.”

This content was originally published here.

Embracing the future of dentistry: Rendezvous Dental now offering Tele-dentistry

The future of medicine as we know it is evolving, whether we like it or not. You may have even heard the term “telemedicine” in recent talks about healthcare.

With the introduction of internet and technology, a world of possibilities could open up; from access to top medical professionals all over the world, to medical assessments conducted from the comfort of your home.

The ability to diagnose (and in some cases, treat) remotely are made possible. For obvious reasons, this new technology could have some positive implications for rural communities like ours.

As healthcare as we know it evolves, the same rings true for oral health. The dental field is adopting Tele-dentistry which involves “the exchange of clinical information and images over remote distances for dental consultation and treatment planning.” .

What does this mean for patients?
For you, the patient, this could mean access to better oral healthcare, online consultations, and in some cases lower costs. For example, you can now get a professional opinion from your dentist without taking time off work or pulling your kid out of school.

Here locally, Rendezvous Dental is embracing the future of dentistry.
Forward-thinking dentists, like Dr. Colton Crane at Rendezvous Dental are already using this cutting-edge technology to improve the patient experience.

Let’s try it!
Tele-dentistry with Rendezvous Dental is easy. Visit their website and follow the instructions. Fill out the online form, describe your concern in detail, and attach two images from different angles. For just $25, you can have a response from Dr. Crane within 2-3 hours (during business hours)!

In most cases this is enough for Crane to decide if your problem is cause for immediate concern or something that can wait until your next cleaning. In a pinch, antibiotics could be prescribed too. Should an x-ray or further exam be in order, Rendezvous Dental will apply your $25 as a credit.

This new service is currently available online at rendezvousdental.com/tele-dentistry. For more information, call Rendezvous Dental at  or stop by their office at 312 N 8th St. W. in Riverton.

This content was originally published here.

Using AI to improve dentistry, VideaHealth gets a $5.4 million polish

Florian Hillen, the chief executive officer of a new startup called VideaHealth, first started researching the problems with dentistry about three years ago.

The Massachusetts Institute of Technology and Harvard educated researcher had been doing research in machine learning and image recognition for years and wanted to apply that research in a field that desperately needed the technology.

Dentistry, while an unlikely initial target, proved to be a market that the young entrepreneur could really sink his teeth into.

“Everyone goes to the dentist [and] in the dentist’s office, x-rays are the major diagnostic tool,” Hillen says. “But there is a lack of standard quality in dentistry. If you go to three different dentists you might get three different opinions.”

With VideaHealth (and competitors like Pearl) the machine learning technologies the company has developed can introduce a standard of care across dental practices, say Hillen. That’s especially attractive as dental businesses become rolled up into large service provider plays in much of the U.S.

Screen Shot 2019 09 16 at 16.33.16 1

Image courtesy of VideaHealth

Dental practitioners also present a more receptive audience to the benefits of automation than some other medical health professionals (ahem… radiologists). Because dentists have more than one role in the clinic they can see enabling technologies like image recognition as something that will help their practices operate more efficiently rather than potentially put people out of a job.

“AI in radiology competes with the radiologist,” says Hillen. “In dentistry we support the dentist to detect diseases more reliably, more accurately, and earlier.”

The ability to see more patients and catch problems earlier without the need for more time consuming and invasive procedures for a dentist actually presents a better outcome for both practitioners and patients, Hillen says.

It’s been a year since Hillen launched the company and he’s already attracted investors including Zetta Venture Partners, Pillar and MIT’s Delta V, who invested in the company’s most recent $5.4 million seed financing.

Already the company has collaborations with dental clinics across the U.S. through partnerships with organizations like Heartland Dental, which operates over 950 clinics in the Midwest. The company has seven employees currently and will use its cash to hire broadly and for further research and development.

Screen Shot 2019 09 25 at 2.53.42 PM

Photo courtesy of VideaHealth

This content was originally published here.

How USC students deal with physical stress caused by dentistry

Minalie Jain had experienced pain before, but when she started to work in the simulation lab at USC, the shooting pain in her arm caught her attention.

The sim lab involves a lot of fine handwork, with students bent over molds of teeth. The intensity of the muscle contractions left Jain in stabbing and throbbing pain.

Fortunately for her, the Herman Ostrow School of Dentistry of USC and the university’s physical therapy program have teamed up to use physical therapy skills that can help dental students deal with the physical stress caused by dentistry. Jain now does physical therapy to help her in day-to-day work.

Physical stress: Ergonomics and body mechanics offer relief

Dental students had always had one lecture on ergonomics from a physical therapy professor, but when Kenneth Kim, instructor of clinical physical therapy, took over that lecture, he thought the schools could do more together.

“I felt like a lecture once a year wasn’t enough — especially because we were seeing so many dental students at the clinic,” he said. “Sometimes the students were getting pretty emotional because of all the pain.”

Kim worked with Jin-Ho Phark, associate professor of clinical dentistry, to set up the ergonomics and body mechanics collaboration after the lecture. This is the first year that physical therapy students go to the dental students’ sim lab once a week, for two hours in the morning and two hours in the afternoon. “We can follow up on body position and patient position, and they have been really receptive,” Kim said.

The biggest issues that dental students face are forces on their hands, necks and arms as they work on models of patients.

They sometimes forget to adjust the patient to make their own bodies work more easily.

Kenneth Kim

“They sometimes forget to adjust the patient to make their own bodies work more easily,” Kim said. “That means that students can stay hunched over, in that position for hours, which causes neck and back pain. We come in and make a small adjustment, which results in a huge outcome.”

Musculoskeletal disorders: a widespread problem

Dentists are particularly prone to musculoskeletal disorders: 70 percent of dentists suffer from them, compared to 12 percent of surgeons. That’s mainly because dentistry requires lots of repetitive motions, especially by the hand and wrist, as well as sustained postures, said Phark says, who explained that students in the sim lab work on mannequins, learning to use drills inside tooth models. The way they position their necks forward or slouch their backs can often result in lower back and shoulder pain.

“We see that throughout the years students in dental school don’t always take care of their posture while they perform procedures,” he said. That’s hard on a body, especially considering students are working in the same position for eight hours a day.

In addition to the lectures and hands-on help, students can often position themselves better by using their loupes, which allows them to maintain a certain distance from a patient.

“With lenses on the loupes, you can’t really adjust them so there is a working length in which they have to position themselves,” Phark said.

Sit for some patients and stand for others

Kenneth Gozali uses his loupes to remind himself to keep a good posture and position with patients. He focuses on sitting straight, having the right chair height and patient height — all of which make it easier to do his work.

“It was a little strange because I was not all that used to sitting all day, but now I like to switch it up: I’ll sit down for two or three patients and then stand up for the next ones,” he says, adding that in dentistry it’s all about keeping your hands and arms in good working order. “You can’t do much with a bad back or bad arm.”

Phark has used the collaboration as a refresher in his own work: He noticed there were days when he came home in pain.

“My back is hurting, my neck is hurting, I have to maintain a proper posture myself,” he said. “It’s not just preaching — we have to practice ourselves.”

Phark works on Wednesdays in the USC Dental Faculty Practice for 12 hours. “I basically cannot survive the day if I’m not sitting properly,” he said.

Two-way education

The dental students have been very receptive to the instruction and advice, since many of them experience a variety of issues that we can help them navigate and problem solve, whether it is pain, fatigue or difficulty visualizing target areas within the mouth, said Ashley Wallace, who has also learned things from the dental students

“I’ve learned the dentistry-specific language in regards to quadrants and tooth surfaces, and how the position of both the patient and dentist change depending on the target surface, procedure and tools required or whether direct or indirect vision is used.”

Wallace said it’s been valuable to adapt her training to a specific audience such as the dental students.

“My hope is that if they implement proper body mechanics now, they will have less need for physical therapy down the road.”

It takes three weeks to break a habit

Kim hopes to continue and expand the collaboration in the coming years. This year, physical therapy students are only working in the dental school for five weeks — and they are trying to figure out how to do more in the future.

“For the first year, five weeks is pretty good,” Kim said. “It takes three weeks to break a bad habit, like slouching or stooping. With our presence, we can get them to be more mindful about their posture going forward.”

Jain will continue to do physical therapy exercises, which she said are helping her pain. An X-ray showed calcified tendonitis in her rotator cuff, a genetic condition that was exacerbated by her dental school work. She’s grateful for the extra perspective and help she gained from the collaboration.

“Ergonomics is very crucial in dental school because forming a bad habit is really easy since it is very difficult seeing in the mouth,” she said. “It is important to keep the back straight and the arms in appropriate positioning so it doesn’t cause strain on it, even for people who do not have arm issues.”

This content was originally published here.