Brian B. Nový, DDS, FADI

Transcription

1 Brian B. Nový, DDS, FADI

2

3 PG-13 This lecture has been rated DENTAL PROFESSIONALS STRONGLY CAUTIONED SOME MATERIAL MAY BE INAPPROPRIATE FOR THOSE EXPECTING A BORING LECTURE The speaker is likely to use moderate language, refer to God, scream, discuss drug content, peril, violence, and/or create cognitive dissonance.

4

5 PG-13 This lecture has been rated DENTAL PROFESSIONALS STRONGLY CAUTIONED SOME MATERIAL MAY BE INAPPROPRIATE FOR THOSE EXPECTING A BORING LECTURE The speaker is likely to use moderate language, refer to God, scream, discuss drug content, peril, violence, and/or create cognitive dissonance.

6 26,27,28

7

8 4.4

9 It is paradoxical that the hardest of all tissues is so susceptible to lesions in living humans, while it is the most indestructible in the dead.

10

11 We concentrate on things we already know and time and time again fail to take into consideration what we don t know We fool ourselves into thinking we know more than we actually do.

12 Fred McKay s first patient:

13 An Endemic Developmental Imperfection of the Teeth, Heretofore Unknown in the Literature of Dentistry

14 Meet Derek

15 Derek s mouth kept me up at night I searched the literature for answers I expected to easily locate everything I missed in cariology class I discovered caries brings out the worst in some people

16 There s a lot of information out there Caries Research has been published monthly* for over forty years Caries is the most prevalent disease in the world S. mutans is the second most popular organism in all of the scientific literature

17

18

19

20

21

22

23

24

25 Dental Histology 1927

26 That contradicts what I was taught! Eating candy causes cavities Brushing your teeth prevents cavities Flossing your teeth prevents interproximal cavities People with excellent oral hygiene don t get cavities

27

28 In light of the results of this comprehensive literature search and critical analysis, it is concluded that a routine instruction to use floss is not supported by scientific evidence. Impact factor =.871 Intl J Dent Hygiene 6: 2008,

29 IF= Total # of citations this year Total # of articles in last two years Most editors would be happy if their journal had an impact factor of 4.

30 Systematic Reviews Randomized Controlled Trials Cohort Studies There s more to it than impact factors Case Control Studies Case Reports Expert Opinion Common sense Brian Nový s opinion

31 dental floss should reduce interproximal caries risk self-flossing has failed to show an effect. Impact factor = 3.486

32

33 Bacteria levels Baseline: fg Sm DNA fg total DNA 1.69x x10 9 Ten long days without flossing (in the name of science) Final: Ratio = fg Sm DNA fg total DNA Ratio = x x %.0145%

34 Hi Aaron

35 Let s do a Caries Risk Assessment

36

37

38 The panel concluded with high certainty that in children and adults, the use of 0.5% and 0.12% chlorhexidine rinse does not reduce the incidence of coronal caries.

39

40

41 Remember Dr. Keyes?

42 Keyes Non-Specific Plaque Hypothesis Time Plaque Teeth DECAY (caries) then he became controversial

43

44 I think I ll write a paper

45 Keyes Technique 1978 NIH researcher, Dr. Paul Keyes published a technique/article MMPT: Microbiologically Monitored Periodontal Therapy Became known as The Keyes Technique

46 In 1980 Dr. Keyes went on daytime television

47 Keyes Technique Tenets: Brushing, flossing, scaling Baking soda Hydrogen peroxide Waterpik with salt water Tetracycline Bacteriologic monitoring

48 Like a pack of Ninjas, they pounced Seems like everyone began to attack Dr. Keyes and his Technique General Dentistry Journal of Periodontology Journal of Clinical Periodontology International Journal of Periodontics and Restorative Dentistry

49 You know it s a bad day when The AAP gets involved Keyes was rebuked with Position Papers

50 Hey AAP! It s 1998 and the last cited reference you used was from 1990 don t you think it s time to reexamine the Keyes Technique? NO SHUT YOUR FACE!

51 In May of 2005 the Board of Trustees of the American Academy of Periodontology rescinded the position paper and clinical guidelines [concerning the Keyes Technique] Maybe it works!

52 A dentist needs to evaluate honestly whether results of a scientific study are to be believed and trusted because of a wish they were true or because of the scientific rigor of the study. -Dr. Michael Glick