Sophia C. Kladias, DMD
Complete Health Dentistry
for Adults and Children

Dentistry in the News

October 30, 2015

Researchers Link Hookah Use To Serious Oral Conditions.

PRNewswire (10/29) carries a press release on a new study which “found that waterpipe smoking is associated with serious health problems affecting the head and neck region,” according to study author Teja Munshi, BDS, MPH of Rutgers University. Researchers found hookah or “waterpipe smoking to be associated with gum diseases, dry socket, oral cancer and esophageal cancer among other conditions.” The World Health Organization found that “smoking a hookah is the equivalent of smoking 100 cigarettes, based on the duration and number of puffs in a smoking session.” The ADA “has long been a proponent of educating the public about its hazards and has urged for continued research into the adverse health effects of tobacco use.” Additionally, provides information on the dangers of alternative forms of tobacco and an editorial in The Journal of the American Dental Association “warned readers of the potential dangers of e-cigarettes.”

Dr Bicuspid (10/29) reports that JADA Editor Michael Glick, DMD, said that the “study sheds light on the common misconception that smoking from a water pipe is somehow safer than smoking a cigarette. Whether you are smoking a cigarette, an e-cigarette, a cigar, or tobacco from a water pipe, smoking is dangerous not only to your oral health but to your overall health.”


March 30, 2013 - Infection Control

As you are probably aware, there is widespread news coverage involving the investigation of an Oklahoma oral surgeon for allegedly poor infection control practices and delegation of dental procedures. The ADA is monitoring this developing story closely.

I want to assure you that in my dental practice, we follow stringent infection control procedures.

Also, as your dentist, I would only delegate procedures to my staff that they are licensed or qualified to perform per state regulations. I care about my patients and your health and safety are my foremost priorities.

Studies show that following proper infection control procedures greatly reduces risk to patients to the point of an extremely remote possibility.

The Centers for Disease Control and Prevention has developed special recommendations for use in dental offices.

Let me describe just a few of the things that we do in my practice in terms of infection control:

• All dental staff involved in patient care wash their hands and use appropriate protective garb such as gloves, masks, gowns and eyewear

• A new set of gloves and masks are used for each patient.

• Before you enter the examining room, all surfaces, such as the dental chair, instrument tray, dental light, drawer handles and countertops, have been cleaned and decontaminated.

• Non-disposable dental instruments are cleaned and sterilized between patients. In my office we sterilize instruments using an autoclave which involves steam under pressure. Please let us know if you would like to see our sterilization area.

• Disposable items like needles or gauze are placed in special bags or containers for special, monitored disposal.

• Your well-being is important to me and my staff, which is why we follow stringent infection control procedures and comply with all state regulations for the protection of patients.

• You can visit the American Dental Association’s website at and use the search term “infection control” to see a video on this topic. The website has a lot of information to help you take care of your oral health, too.


American Dental Association: Dental X-rays Should be Used Sparingly To Reduce Radiation Risk

Contact Information:

Telephone: 312-440-2806
E-mail: (Journalists) or Contact ADA (All Others)

CHICAGO, April 10, 2012 —The American Dental Association (ADA) is aware of a recent study that associates yearly or more frequent dental X-rays to an increased risk of developing meningioma, the most commonly diagnosed brain tumor. The ADA’s long-standing position is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment. Since 1989, the ADA has published recommendations to help dentists ensure that radiation exposure is as low as reasonably achievable.

The ADA has reviewed the study and notes that the results rely on the individuals’ memories of having dental X-rays taken years earlier. Studies have shown that the ability to recall information is often imperfect. Therefore, the results of studies that use this design can be unreliable because they are affected by what scientists call "recall bias."   Also, the study acknowledges that some of the subjects received dental x-rays decades ago when radiation exposure was greater.  Radiation rates were higher in the past due to the use of old x-ray technology and slower speed film.  The ADA encourages further research in the interest of patient safety.

As part of the ADA’s recommendations to minimize radiation exposure, the ADA encourages the use of abdominal shielding (e.g., protective aprons) and thyroid collars on all patients. In addition, the ADA recommends that dentists use E or F speed film, the two fastest film speeds available, or a digital x -ray.

In addition to the X-ray recommendations, the ADA’s Council on Scientific Affairs will publish clinical guidance on the use of cone-beam computed tomography in an upcoming issue of The Journal of the American Dental Association. The ADA will share these recommendations as soon as they are available.

Dental X-rays are valuable in helping dentists detect and treat oral health problems at an early stage. Many oral diseases can’t be detected on the basis of a visual and physical examination alone, and dental X-rays are valuable in providing information about a patient’s oral health such as early-stage cavities, gum diseases, infections or some types of tumors. How often dental X-rays should be taken depends on the patient’s oral health condition, age, risk for disease and any signs and symptoms of oral disease that the patient might be experiencing.

The ADA encourages patients to talk to their dentists if they have questions about their dental treatment. As a science-based organization, the ADA fully supports continuing research that helps dentists deliver high-quality oral health care safely and effectively.

Additional information about dental x-rays is available on


About the American Dental Association

The not-for-profit ADA is the nation's largest dental association, representing more than 156,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit the Association's website at


February 16, 2012 - FDA Cautions Consumers about Faulty Electric Toothbrushes 

The U.S. Food and Drug Administration today issued a warning to consumers that the battery-powered Arm & Hammer Spinbrush—or the Crest Spinbrush, as it was called before 2009, can break during use, causing damage to teeth and other tissues and even present a choking hazard.


Here are some excerpts from the report:

Toothbrush Can Chip Teeth and Cause Choking

When using your electric toothbrush, you don’t expect parts of the device to pop off and chip your tooth, fly into your eyes or get stuck in your throat. But that’s exactly what has happened to some users of the battery-powered Arm & Hammer Spinbrush—or the Crest Spinbrush, as it was called before 2009.

Injuries reported from using the Spinbrush powered toothbrush include

  • chipped or broken teeth
  • cuts to the mouth and gums
  • swallowing and choking on broken pieces
  • injury to the face and eyes

FDA is alerting the public about the potential for injury while using the following models of Spinbrush:

  • Spinbrush ProClean
  • Spinbrush ProClean Recharge
  • Spinbrush Pro Whitening
  • Spinbrush SONIC
  • Spinbrush SONIC Recharge
  • Spinbrush Swirl
  • Spinbrush Classic Clean
  • Spinbrush For Kids
  • Spinbrush Replacement Heads

Advice to Parents, Caregivers and Consumers

  • Before using the Spinbrush, inspect it for any damage or loose brush bristles. If you find any, do not use the brush. Report it to Church & Dwight, which can be reached toll-free at 1-800-352-3384 or 1-800-561-0752.
  • Make sure the brush head is connected tightly to the brush handle, and test the brush outside of your mouth before using. If the connection feels loose or the brush head easily detaches from the handle, do not use the brush. Report it to Church & Dwight.
  • Use care not to bite down on the brush head while brushing.  
  • To prevent injuries, always supervise children and adults who may need assistance when using the Spinbrush.
  • Follow the instructions and recommended replacement guidelines included with the Spinbrush.
  • Report injuries or problems with the Spinbrush to MedWatch—FDA's Safety Information and Adverse Event Reporting Program either online, by regular mail, by fax or by phone.
    • Online
    • Regular Mail: Use postage-paid, pre-addressed FDA form 3500
    • Fax: 800-FDA-0178
    • Phone: 800-332-1088 

  • A new study in the Journal of Dental Research finds bone fluoride levels are not associated with osteosarcoma, a rare bone cancer more prevalent in males.

    A team of researchers from Harvard University, the Medical College of Georgia and the National Cancer Institute analyzed hundreds of bone samples from nine hospitals over an eight year period from patients with osteosarcoma and a control group to measure fluoride levels in the bone.

    Considered the most extensive study to date that examines a potential association between fluoride levels in bone and osteosarcoma, the results indicated no correlation. Three branches of the National Institutes of Health were involved in the study. The National Cancer Institute (NCI) approved the design of the study, and funding for the research was provided by the NCI, the National Institute of Environmental Health Sciences, and the National Institute of Dental and Craniofacial Research.

  • This new study adds to an already strong base of scientific evidence that fluoride is safe and effective at preventing cavities.

  • An inconclusive animal study conducted twenty years ago first raised the question of an association between fluoride and osteosarcoma. Since that time, other studies have examined the issue.

  • This new study is considered by researchers to be the best science to date because a more accurate and reliable scientific method was used to measure exposure from all sources of fluoride.

  • Tooth decay rates have declined dramatically over the past several decades, thanks in part to the use of fluoride.

  • The American Dental Association advises that you should brush twice a day with fluoride toothpaste, floss daily, eat a balanced diet and maintain regular dental appointments to help prevent tooth decay.

 June 24, 2011

Cigarette ads, packages must include oral cancer warnings, says FDA

Washington—The Food and Drug Administration will require use of a “cancerous lesion on lip” image in cigarette advertising and packaging for its potential to motivate positive behavioral change, influence youth and young adults in particular and inform the public that cigarettes cause oral cancer.

Image: Food and Drug Administration “cancerous lesion on lip” image

Flexing its regulatory muscle on the second anniversary of the Family Smoking Prevention and Tobacco Control Act, which was signed into law June 22, 2009, the FDA unveiled nine graphic health warnings to be placed on all cigarette packs, cartons and ads no later than Sept. 22, 2012.

“The nine new health warning statements and the accompanying graphic images selected by FDA convey information that is factual and uncontroversial,” the agency said in the regulatory notice.

The FDA simultaneously announced a public inquiry and request for comments on the public health impact of modified risk tobacco products sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products. The FDA scheduled a public forum Aug. 25-26 to obtain information on “the scientific issues associated with assessment and ongoing review of MRTPs.” These include smokeless and other products promoted as alternatives to cigarette smoking.

The Association supported the 2009 tobacco control law, and has advised the FDA on using the law to shape public tobacco policy. “Dentists are the first line of defense in the war against oral cancer and many other tobacco-related diseases,” the Association told the FDA in commenting on tobacco product regulation.

“As a matter of public health, we have become increasingly alarmed by recent attempts to market smokeless tobacco as a healthier (or less harmful) alternative to cigarettes,” the Association’s Oct. 9, 2009 statement said. “Smokeless tobacco is not a healthy alternative to cigarette smoking; both products pose health risks.”

FDA issued the requirement for larger, graphic health warnings for cigarette packages and advertisements in a June 22, 2011 Federal Register document dense with analysis and research rejecting tobacco industry arguments against the proposal and explaining how and why these images and warnings will get public attention and reduce smoking-related disease and death.

An image the FDA describes as “cancerous lesion on lip” will illustrate a “WARNING: Cigarettes cause cancer” statement chosen, the agency said, for scoring high in focus group testing on emotional and cognitive reaction scales and a “difficult to look at” measure.

“First, ‘cancerous lesion on lip’ was the only image among the images proposed for use with this warning statement that had a positive impact on beliefs about the health risks of smoking and secondhand smoke exposure in one of the study samples (adults viewing a hypothetical advertisement),” the FDA said in the regulatory document.

“Furthermore, as is stated in several comments…the selected image ‘cancerous lesion on lip’ is likely to have particular relevance for youth. As explained in some of these comments, the research literature suggests that youth are likely to relate to and be susceptible to cigarette warnings depicting the negative short-term impacts of smoking on their personal appearance, including their lips and teeth.

“Several comments noted that the image could be especially effective with younger audiences and could positively influence such audiences by illustrating how the health effects caused by smoking negatively affect their physical appearance. The comments indicated that adolescents can relate to and will be susceptible to this message.

“We agree with these comments,” the FDA said in responding to the comments on image effectiveness. “It is important to include content in the required warnings that is relevant to youth. The image ‘cancerous lesion on lip’ has the potential to positively impact youth behavior in addition to adult and young adult behavior.”

The FDA disagreed with comments that the image was “too gross” to be effective and that oral cancer was an odd choice of cancers to depict in the graphic warning, noting that “the research literature indicates that images that evoke strong emotional reactions can promote greater awareness and better recollection of the health risks of smoking and can increase the likelihood smokers will reduce their smoking, make an attempt to quit, or quit altogether.

“Furthermore, the choice of cancers depicted in the required warning is appropriate and will help inform the public that cigarettes cause oral cancers and thus increase public awareness of the negative consequences of smoking.”

The National Tobacco Quitline phone number, 1-800-QUIT-NOW, must accompany the nine new warnings.

Information for professionals and the public to assist in tobacco cessation efforts can be found on

Sept 7, 2010 - Dental Materials and Bisphenol A (BPA)

  • Dental sealants and composite resin fillings have been used for many years. Sealants prevent tooth decay and composite resins are tooth-colored dental fillings.
  • Resin-based sealants and composite resins are made from plastic. Some types of plastic have been in the news lately because of a chemical called Bisphenol A (BPA), a chemical that acts like estrogen. Some studies with laboratory animals suggest a disruption in normal hormone activity. This has led to speculation about the effect of BPA on humans.
  • BPA is a synthetic chemical resin used in plastics. In dentistry, its derivatives - bisphenol A-glycidyl methacrylate (bis- GMA) and bisphenol A dimethacrylate (bis-DMA) - can be found as a byproduct in the manufacturing process of resin-based dental sealants and composite resins.
  • BPA is rarely used as an ingredient in dental materials but may be present as a by-product or trace material leftover from the manufacture of other ingredients used in dental composites or sealants. An article that was just published in a medical journal assessed various existing studies on dental materials and BPA. Trace amounts of BPA may be present in the saliva a few hours after placement of resin-based sealants containing bis-DMA, but based on current evidence, the American Dental Association believes that this low level and brief exposure time poses no known health risk.
  • The measurable exposure to BPA from sealants occurs one time - at the time of placement - and is about 200 times lower than the daily level EPA considers safe. Dental materials are far less likely to cause BPA exposure than other consumer goods such as plastic bottles and linings of metal cans.
  • The researchers say sealants and composites should continue to be used because of their proven benefits which outweigh potential risks of BPA. The researchers also say that BPA exposure can be reduced if a newly-placed sealant or composite filling is rinsed or wiped immediately after placement.
  • Please know that I have composite dental fillings as well as dental sealants in my own mouth. None of our composite resins or sealant materials contain BPA, however some of them contain bis-GMA, which does not break down into BPA after coming in contact with enzymes in saliva like bis-DMA does. Nonetheless, we routinely wipe and rinse our sealants and composite resins of this residue after placement as per the researchers.
  • As your dentist, I want to answer any questions you may have about your dental treatment. In our office, we use UltraSealXT Plus sealant material from Ultradent Products, Inc. You may visit the Ultradent website for more information. In addition, you may also visit the American Dental Association's Web site at regarding this topic.




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