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SUMMARY: This article evaluates the effectiveness of hand-held X-ray units versus standard wall-mounted units in producing high-quality diagnostic images. Through a series of studies using many different statistical methods, it determined whether one type of X-ray unit offers advantages over the other. This article concludes that the hand-held unit is equally effective in generating quality diagnostic images compared to the wall-mounted unit, while also offering the added benefit of ease of use and ability to learning the techniques quickly.

DOES THE ARTICLE SUPPORT THE USE OF THIS TECHNOLOGY: Yes, this article supports the use of this technology and, the study proves that using the Hand-held has the same benefit when compared to WM x-ray. Additionally, incertain circumstances the operator may benefit from the portability of the hand-held.

3. DESCRIPTION AND INFORMATION REGARDING TECHNOLOGY: Handheld unit designed for dental intraoral radiography.

4. ADVANTAGES: Image quality (comparable to wall mount unit), portability, patient comfort (pt with mobility issues), reduced setup time, and operator convenience.

5. DISADVANTAGES: Some limitations would be operator error, battery limitations, radiation exposure, and cost.

6. COST: this article does not specify the exact cost of the device, just states it can be a higher initial investment when compared to the traditional wall-mounted devices.

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Image quality of a portable X‑ray device (Nomad Pro 2) compared to a wall‑mounted device in intraoral radiography

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1. 3 peer reviewed journal articles regarding the technology

a. Links to full-text articles (not abstracts) or in PDF form. Make sure links are in working order! If you find an article on the library database, please download the PDF from the library website and then upload to Padlet. This way you will have it for future reference. Links to the library databases are only

available while you are a student. PDF’s are ideal as websites and links can change.

2. Short summary of articles. Does the article support the use of this technology?

3. Description and information regarding technology

4. Advantages

5. Disadvantages

6. Cost

7. Optional info you may want to include: company sales rep contact information, your opinion, links to comparative products

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SUMMARY: SUMMARY: This article explores the pros and cons of hand-held dental X-ray units. Among the advantages are their portability, the ability to remain with the patient during the procedure, a reduction in retakes, and ease of use for both children and geriatric patients. The disadvantages, include not adhering to the ALARA principle, the need for proper angling of the device—which can increase radiation risk—and the potential requirement for lead aprons for both patients and operators. In conclusion, the hand-held X-ray unit is user-friendly, follows safety standards, is time-efficient, and portable, making it suitable for nursing homes and use with children.

DOES THE ARTICLE SUPPORT THE USE OF THIS TECHNOLOGY: This article supports the use of handheld X-ray technology, highlighting its portability, which helps with nursing home visits, improves time efficiency, and helps facilitate x-rays on children who may have difficulty staying still.

3. DESCRIPTION AND INFORMATION REGARDING TECHNOLOGY: Handheld x-ray units are compact, portable devices designed for ease of use in dental radiography.

4. ADVANTAGES: lightweight, diagnostic image capability, battery-powered, user friendly, and portable.

5. DISADVANTAGES: operator dependency, radiation exposure, battery limitations, and cost.

6. COST: this article does not specify exact cost of the unit, just mentions that these can be a significant investment.

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SUMMARY: This article outlines the techniques or guidelines for the handheld gadget. These include Uses, recommendations, radiation protection, training, and image quality. This article includes the importance of using this device in certain situations when the Wall mount X-ray may not be possible.

DOES THE ARTICLE SUPPORT THE USE OF THIS TECHNOLOGY: This article advocates for the use of handheld X-ray units, but emphasizes their application only in "justified situations," particularly when compared to the other two articles. Key considerations for their use include clinical justification, specific patient circumstances (such as emergencies or remote locations), operator training, radiation safety, quality assurance, and regulatory compliance. After evaluating these factors, dental professionals can make informed decisions regarding the appropriate use of handheld X-ray units.

3. DESCRIPTION AND INFORMATION REGARDING TECHNOLOGY: Hand Held X-ray equipment, which is battery-powered, portable and designed to be used when held in the hands of the operator during exposure.

4. ADVANTAGES: flexibility, portability, immediate imaging, reduced radiation exposure, patient comfort, and ease of operation.

5. DISADVANTAGES: increase chance of operator error, battery limitations, radiation exposure, limited field of view, and training requirements

6. COST: does not specify cost.

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Justification and good practice in using handheld portable dental X-ray equipment- a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR)

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6. COST: "Portable X-ray machines are more affordable, with prices ranging from $5,000-$60,000"

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What Is the Average Cost of an X-Ray Machine? [Updated 2024]

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An X-ray machine can be a big part of the budget for a medical office. Learn the average cost of an X-ray machine in 2024 to make an informed purchase!

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This article highlights how 3D intraoral scanners can capture digital impressions of patients' oral structures. These scanners help to improve the accuracy and efficiency of dental procedures. It lists the advantages, applications and future trends of using these scanners. Uses or applications of these scanners consist of restorative procedures, which include fabrication of crowns, bridges, and orthodontic liners like Invisalign. And lastly, it touches on the future trends of these scanners such as the potential use of this technology in every dental practice. Does this article support the use of the technology?:

This article believes it is up to the specific dentist to determine if it is more effective than other dental technology. It states that each technology has pros and cons.

I would describe these scanners as; using three-dimensional scanning of the mouth to create detailed 3D maps of the oral cavity for accurate digital impressions, crowns and bridges.

Some advantages of using these scanners within dentistry consists of; enhanced patient comfort, reduced chair time, and better communication between the patient and the dental professional.

Disadvantages include instability, transport/packaging, delamination, geometrical and dimensional inconsistencies between the plaster model and the real teeth.

Lastly cost, sadly this article does not state an actual cost but states: "main advantage is the low cost of these systems, make of few and cheap components" about the Triangulation techniques and devices.

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ORTHODONTIC ALIGNERS: INVISALIGN ARTICLE #2

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ORTHODONTIC ALIGNERS: INVISALIGN ARTICLE #2

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This article evaluates the efficacy of tooth movement using Invisalign, focusing on whether improvements have been made in the aligner's performance over time. It talks about patients using these liners with Invisalign, and measures the outcomes to assess the accuracy and efficiency of tooth movement. The findings suggest that advancements in the technology and design of Invisalign have positively impacted treatment results, indicating improved efficacy compared to earlier versions. This article also highlights the importance of continued assessment and study of orthodontic tools to ensure the best patient outcomes.

Does this article support the use of intraoral scanners?: yes, it talks about the advantages when compared to older developments of Invisalign liners.

This article descibes invisalign as an Individual fit retainer that is done through intraoral scanning systems. These liners help shift crowded teeth and develop a more straight smile.

Advantages of having invisalign done throught the process of scanners is that it they are clear compared to orthodontic brackets. Less need for frequent checkups to orthodontist, and more patient comfortability.

Disadvantages of clear aligners as stated in the article; "The overall mean accuracy of Invisalign was 50%." This is not the greatest percentage of change in the dentition given that they are supposed to be the alternative option of braces.

Price is not specified within the article. But according to the Itero reps that came in a talked during class, Invisalign aligners range from $5,000-6,000.

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This article provides an overview of intraoral scanning technology in dentistry. It explaines the working mechanism of intraoral scanners, their role in capturing digital impressions of patients' oral cavities. Uses for these scanners consist of orthodontics, prosthodontics, and restorative dentistry.

DOES THE ARTICLE SUPPORT THE USE OF THIS TECHNOLOGY: Yes, this article does support this technology by stating various advantages of using these scanners.

Intraoral scanners are advanced dental devices that are used to capture precise 3D images of the oral cavity.

Advantages of Intraoral cameras consists of :Accuracy in impression, efficiency in time, and comfortability with the dental professional and the patient.

Disadvantages of this technology is the initial cost is a disadvantage, and the need for moisture control

Initial investment in acquiring intraoral scanners and associated digital technologies can be substantial, exact cost of these products are not specified within this article

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COST:

Entry-Level Scanners: $15,000 to $25,000

Mid-Range Scanners: $25,000 to $35,000

High-End Scanners: $35,000 to $50,000+

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How Much Does an Intraoral Scanner Cost in 2024

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Today, we’re answering one of our most frequently asked questions related to scanning... “how much does an intraoral scanner cost today?”

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This article talks about the use of oral microbial biofilm models in the testing of anti-cariogenic agents. Anticarcinogenic agents help prevent/treat dental caries. It talks about oral biofilms, and how it is built of complex communities of microorganisms that form on tooth surfaces and play a vital role in the development of caries. Additionally, it talks about the researchers that developed biofilm models replicating the oral environment's natural conditions, providing a valuable tool for studying the behavior of these microbial communities and evaluating potential anti-caries treatments.

This article supports the use of technology and says that these tactics have to take into account study objectives, pharmacokinetics, and growth agent, substrate selection, inoculum, and growth medium.

These vitro oral biofilm models help stimulate complex microbial communities on tooth-like surfaces. Which in addition, helps evaluate treatments that prevent tooth decay and disrupt biofilm

Advantages of the CDFF model is that large number of biofilms can be replicated and produced and the resultant environment is similar to that of the oral cavity as the medium flows over the substrata in thin films, mimicking saliva flow.

The disadvantages of using such inocula, however, are numerous. The site and subject specific diversity of the inocula make analysis and quantification of the composition of the resulting microbial communities extremely difficult.

Cost: does not specify cost.

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2. Short summary of articles: This article talks about the use of microbiological testing and the association of this testing with the treatment of periodontal disease. It talks over the advantages and disadvantages of using this technology. Use of this technology is the most useful or has the greatest utility when used on a patient with chronic or aggressive periodontitis who does not respond to conventional therapy.

This article supports the use of this technology by backing up the technology with many advantages. Advantages including: help identify cariogenic bacteria, help dental professional treatment plan, help with monitoring biofilm levels and helps determine the future OHI for the patient.

Disadvantages of this technology are cost, time-consuming, false negatives/positives, interpretation challenges, difficult interpretation.

Cost: this article does not specify cost

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This article talks about the effectiveness of plaque-disclosing agents (PDA) in aiding a dental professional in biofilm detection and removal. This article includes a randomized controlled trial to assess whether PDAs improved the removal of biofilm by professional compared to standard cleaning procedures.

This article supports the use of disclosing agents/microbial testing and this technology can be defined as colored dyes that are scientifically created to stick to oral biofilm. These dyes temporarily stain the dental biofilm purple making it more visible for dental professionals.

Advantages of this technology is that it helps aid in the education of the patient, helps reduce biofilm count in the mouth, and helps the dental professional in cleaning off the biofilm. Other advantages would be immediate feedback.

Disadvantages would be that it can be time consuming, given the limited time a dental hygienist has with the patient.

Cost: this article does not specify cost.

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Int J Dental Hygiene - 2020 - Mensi - Plaque disclosing agent as a guide for professional biofilm removal  A randomized

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COST (96 tests): $189

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Biofilm Formation Assay Biofilm Formation Assay Kit Dojindo

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The article explores the growing impact that Artificial Intelligence (AI) has in the field of dentistry. Its proven over time to help improve outcomes, and processes and enhance patient care. AI is being used and integrated into many different dental applications such as ranging from diagnostic purposes, treatment planning, and radiographic interpretation. It also talks about the various advantages and disadvantages of implementing this new technology.

AI or otherwise known as artificial intelligence is a computer science that aims to understand and build intelligent entities, often instantiated as software programs.

Advantages of the use of AI is to improve the accuracy and efficiency of diagnoses, helps with personalized treatment plan for the patients, help with patient communication and patient care, and reduces the risk of missing diagnostic carious lesions.

Disadvantages consist of data privacy or security concerns with personalized patient data, and accountability; such as who will be held responsible for a patient who faces unintentional consequences resulting from error caused by AI technologies.

This article does not specify cost.

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This article examines the potential applications of artificial intelligence within the field of dentistry. This article talks about the opportunities that arise for the use of this technology such as assisting in identifying dental conditions such as carious, periodontitis, and malocclusions by analyzing radiographic images. It can also help with the dental professional develop personalized treatment plan for the patient. This article goes more into depth about describing what AI is, advantages of the use, disadvantages about this technology and cost.

Advantages highlighted within this article consists of improved diagnosis, treatment planning, increased efficiency, personalization of treatment and can help with remote monitoring/tele-dentistry.

AI is an "advanced computational system that leverages vast amounts of data and sophisticated algorithms, particularly machine learning and deep learning, to identify patterns, predict outcomes, and assist clinicians in decision-making processes". It is also described as a transformative and increasingly valuable tool that has the potential to revolutionize the practice of dentistry.

Disadvantages of the use of AI consists of data quality, ethical concerns, the integration process into clinical practice, reliability/transparency, legal liability, dependence on technology, and cost and accessibility.

The cost of introducing AI within the dental workforce is not specified as a dollar amount but it does mention that that cost would be a significant challenge in the adoption of AI technologies within the clinics.

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This article talks over how AI is revolutionzing the field of dentistry particularly through Machine learning and deep learning techniques. It highlights that advantages, disadvantages, applications and cost concerns. It describes AI (Artificial Intelligence) as a transformative technology that leverages computational systems to perform tasks that typically require human intelligence. It allows systems to learn from data and improve their performance over time. The performance consists of pattern recognition, image analysis and predictive modeling.

Advantages of this technology listed within this article consist of improved diagnosis, early detection of carious lesions, increased efficiency and speed, enhanced precision/accuracy, treatment planning, and supports decision-making and accessibility.

Disadvantages of this technology consists of data privacy and security, legal issues, resistance from dental professionals, quality/quantity data, high initial cost and ethical concerns.

Cost is not specified by numbers but the article does have concerns about the high initial cost of the integration of this technology.

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2D Practice: $137/month

3D Practice (Most Popular): $265/month

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The Digital Landscape of Dentistry: Dental AI Software - Diagnocat

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Mistrust towards dentists and dental anxiety are deep-rooted emotional reactions. A lack of understanding, miscommunication, misconceptions, and past negative

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This article analyzes observational studies that examine the effectiveness of oro-facial myofunctional therapy (OMT) and how it can potentially treat obstructive sleep apnea (OSA). The authors within this article support the use of this new and upcoming technology. This article shows data from various amounts of studies to assess whether OMT, can help reduce the severity of sleep apnea. This article would describe OMT or Myofunctional therapy to involve exercises to help improve muscle function in the face and mouth. The results from this article suggested that OMT may have a positive effect on improving sleep apnea symptoms. Advantages of using Myofuncational therapy include reducing the frequency of apneas and improving overall sleep quality, especially when combined with other treatments. One disadvantage is that the author noted that more studies are needed to confirm these findings and better understand the therapy’s role in sleep apnea management.

This article does not specify the cost of Myofunctional Therapy.

products

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(This is the article that was provided from the guest speaker.)

This article discusses how orofacial myofunctional disorders which are problems with the muscles of the face and mouth, can increase the risk of dental malocclusion (misalignment of the teeth) and other craniofacial abnormalities. This author as well as the article supports the use of this technology. This author emphasizes that issues like improper tongue posture, mouth breathing, and poor swallowing patterns can contribute to malocclusion and affect facial development. They suggest in the best interest of the patients that addressing these disorders early through therapies like myofunctional therapy can help prevent or reduce the impact of these dental and craniofacial problems. Advantages of this therapy that are stated within this article consist of improvement of oral function, prevention of malocclusion, support for orthodontic treatment, facilitating craniofacial development, and reduction of symptoms. Disadvantages stated are the need for patient compliance, time-consuming, cost, varied effectiveness from patient to patient, and limited awareness and training.

This article does not specify a specific cost, however, it does state that this therapy can be costly and that this type of therapy is not covered by insurance.

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PURCHASE COURSE
This course was published in the July 2022 issue and expires July 2025. The authors have no commercial conflicts of interest to disclose. This 2 credit hour self-study activity is electronically mediated.

EDUCATIONAL OBJECTIVES

After reading this course, the participant should be able to:

1. Discuss the relationship between orofacial myofunctional disorder (OMD) and malocclusion.

2. Identify the impact of oral habits on the risk for OMD.

3. Explain the role of the dental hygienist in detecting and addressing OMDs.

Orofacial myology focuses on the anatomy, organization, and function of the mouth and facial muscles. An orofacial myofunctional disorder (OMD) is a dysfunctional pattern of the orofacial musculature that interferes with normal growth, development, or proper function of the orofacial tissues. ¹ OMDs can impact individuals of any age, and may negatively affect psychological and functional well-being. The relationship between malocclusion and OMDs and their treatment has received significant attention over the past decade, however, uniform assessment protocols are still needed. ²

OMDs may develop in conjunction with speech and swallowing difficulties, or they may result from a connection between learned behaviors, sleep disorders, physical and structural characteristics, or genetic and environmental influences. ¹ Disruptive oral habits are one of the main contributors to OMDs, including thumb or finger sucking, cheek/nail/cuticle biting, teeth clenching/grinding, and tongue, lip, or cheek sucking. ³ Use of pacifiers, bottles, or sippy cups over prolonged periods may also contribute to OMD development (Table 1). ³ Additional causes are related to structural or physiological abnormalities, such as enlarged tonsils, adenoids, deviated septum, short lingual frenum, and a restricted nasal airway. Neurological disorders, developmental delays, and genetics may also play a role in OMD development. ³

Malocclusion

Malocclusion is a disturbance of the proper relationship between the maxilla and mandible when they come together in occlusion. ⁴ Facial skeletal abnormalities, which are often associated with malocclusion, influence a variety of orofacial functions, including alterations in the locations of bones, teeth, and muscles. Consequently, chewing processes, speech sound articulation, swallowing, and breathing are altered to accommodate the dentofacial environment. ² Dental and skeletal malocclusion may be inherited or acquired, and are often due to developmental abnormalities.

Edward Angle, MD, DDS, who developed the universally accepted system for describing dental occlusion, believed mouth breathing to be one of the most influential and persistent causes of malocclusion. ⁵ Mouth breathing and poor oral habits are risk factors for malocclusion because they may disrupt the normal balance of growth and function throughout development. Mouth breathing is substantially more connected with occlusal issues, with or without a genetic predisposition. Oral habits, on the other hand, are less relevant in the context of malocclusion unless predisposing contributing factors are present. ⁶

The posterior crossbite is associated with both changed tongue position and speech distortion. The posterior crossbite does not self-correct during tooth development, therefore, early intervention is recommended to allow appropriate growth of the craniofacial structures in order to avoid functional speech impairment and maintain healthy tongue posture. ⁷ A systematic review and meta-analysis conducted revealed that the global prevalence of malocclusion is 56%, with the United States at 53%, suggesting that more than half of the US population have some degree of malocclusion. ⁸

Oral habits are learned behaviors that often begin with a physiological need, such as nasal breathing, stress, or adaptation to anatomical limitations, and then become a default mechanism through repetition. ³ Mouth breathing and swallowing are the most common oral habits associated with malocclusion.

Mouth Breathing

Mouth breathing is a risk factor for malocclusion. 6,9 Most commonly occurring during sleep, mouth breathing may be caused by a variety of factors, such as tonsil hypertrophy, septal deviation, nasal polyps, and allergic rhinitis. ⁹ Mouth breathing can cause a broken lip seal, vertical pattern of growth, proclined upper incisors, increased lower facial height, steep mandibular plane angle, and lowering of the chin. ¹⁰

Optimal craniofacial growth and development are influenced by the ability to breathe comfortably through the nose with the lips gently closed and the tongue positioned upward. 11 Lack of muscular pressure on facial bones can negatively impact directional growth over time. Patients with nasal breathing difficulties who subsequently develop a mouth breathing habit typically present with hyperdivergent retrognathic growth patterns that appear as long, narrow, "adenoid" faces, due to its relation to adenoid inflammation. ¹² This phenotype is characterized by an incompetent upper lip, retro positioned hyoid bone, lingualized mandibular incisors, increased anterior face height, narrow maxillary arch, increased mandibular plane angle, and posteriorly rotated mandible. ¹²

In most cases, patients with high vertical growth patterns do not self-correct over time. ¹⁴ These patients present with the most challenging cases for orthodontists to treat because of the skeletal complexity, including the overeruption of teeth due to insufficient occlusal contact. ¹³ Although complete correction may not be attainable, patients should be treated for esthetics and functional improvement. The causes of hyperdivergent growth patterns appear to be environmental due to postural adjustments, particularly forward head posture, related to obstructed airways and weak masticatory musculature (Figure 1). 14 Hyperdivergent growth may also increase the risk of developing a Class II malocclusion. 14,15

Swallowing Patterns

Normal swallowing patterns start with the anterior portion of the tongue placed at the incisive papilla and the dorsum of the tongue completely in contact with the palate. ¹⁵ The action pressure of the tongue against the palate follows the direction of the median palatine suture toward the oropharynx. ¹⁶ When normal movement is inhibited, abnormal swallowing develops as a compensatory movement pattern. ¹⁷ Abnormal swallowing is the interposition of the tongue between or against the teeth. This type of swallowing is typical in infants before tooth eruption; however, during maturation, swallowing changes. ³ Normal adult swallowing is characterized by the tip of the tongue being placed in the palate, the dental arches touching, and the absence of labial contraction. ³

An abnormal swallowing habit usually produces an open bite and may separate not only the anterior teeth but also most of the posterior teeth. If not corrected, the habit will cause the anterior segments to relapse to their former position after the completion of orthodontic treatment. An open bite alone is not always indicative of the abnormal swallowing habit. Interference habits, such as thumb or finger-sucking, lip or nail-biting, and tongue thrusting, can also adversely affect the dentition. ¹⁸ A tongue thrust swallow involves excessive perioral effort, as the tongue exerts forward and/or puts lateral pressure into the teeth, rather than vertical pressure into the hard palate with a front to back motion, reinforcing a low resting tongue posture. 17,19

Breastfeeding

The action of breastfeeding trains the newborn in many healthy chewing and breathing habits. ²⁰ Stimulation of the orofacial muscles is initiated by breastfeeding and continued through mastication. ²¹ The rhythm of sucking to draw milk is a precursor for the rhythm of chewing, as the movement of the masseters, temporalis, and buccinators mimic the act of chewing. ²⁰ Breastfeeding also introduces critical connections between the child's brain and oral habits, as the hypoglossal nerve (cranial nerve XII) powers the tongue to work with deep throat nerves to teach the newborn to swallow, training the airway to be strong and open. ²¹ Furthermore, breastfeeding affects the development of the maxilla and mandible and thus influences dental occlusion. ²¹

Soft Tissue Restriction

Ankyloglossia, or "tongue tie," is a congenital condition in which a thickened, tightened, or shortened lingual frenulum limits movement of the tongue. ²² This condition interferes with feeding, such as mastication, and negatively impacts dental health, sucking, speech, and breathing. ²³⁻²⁶ A short lingual frenulum can lead to oral-facial malformations that may decrease the size of the upper airway. ²³ Lingual frenum restriction can also be a phenotype of obstructive sleep apnea in children, 27 as it may increase the possibility of upper airway collapse during sleep. ²⁸ Consequently, due to the restrictions that a short lingual frenum places on the muscles and tongue, as well as the impediment placed on bone growth, malocclusion may develop.

Proper surgical release associated with myofunctional therapy can result in increased function and improvement in quality of life. When the tongue rests in its proper position on the palate rather than resting on the floor of the mouth, proper sleep, balance, and posture are supported. Furthermore, when the tongue rests on the palate, the muscles responsible for holding the head up and reducing forward head posture and cervical extension are activated. ²⁹

Mastication

Mastication begins in the first year of life and provides the earliest form of input to the oral sensory system. The deep pressure, or proprioception, provided by chewing contributes to the foundation for normal oral movement needed for speech. Chewing aids in the digestion of food, regulates bone growth, reduces psychological stress, increases cognition, 30 and stabilizes the temporomandibular joint. 31 Non-nutritive chewing of objects can influence the development of malocclusion and craniofacial changes, leading to imbalanced and inefficient chewing. ³² Masseter orientation angle and bite force are correlated to different malocclusions, and softer foods require less chewing and less bite force, ³³ therefore the drastic evolution of the human diet from harder to softer food may also be a contributory factor.

Additionally, one OMD may contribute to the development of another. Chewing, for example, can be affected by mouth breathing, as mouth breathing has been shown to reduce chewing cycles and chewing stroke count. ³⁴ Because mastication and respiration are typically accomplished through different routes and mechanisms, masticatory function must be stopped or interrupted during mouth breathing. This is because when nasal breathing is replaced by mouth breathing, the position of the tongue, lips, and mandible are altered to provide an airway through the mouth, which directly affects the chewing process. 10,34

Role of the Dental Hygienist

Orofacial dysfunction may be first recognized by the dental hygienist in a clinical setting. While not traditionally within the scope of dental hygiene practice, numerous state dental hygiene boards, such as Nebraska and Iowa, have declared myofunctional therapy part of the practice of dental hygiene. ¹⁵ More dental hygienists are receiving training and using their knowledge for patient assessment, contributing greatly to early intervention and recognition of myofunctional disorders.

Though effective and reliable guidelines are few, OMD evaluations must include myriad orofacial functions and rely on a variety of disciplines in order to initiate adequate referrals and care for individuals with OMD. ² Dental hygienists must identify the need for referral, as oral myofunctional therapy is an important part of the multidisciplinary approach to treating patients with orthodontic needs, temporomandibular joint disorder, and sleep-disordered breathing.

A chairside clinical assessment will help dental hygienists recognize the presence of OMDs. When performing a chairside clinical evaluation, patients should remain unaware of the assessment so they are present in their most natural state. 35 For example, patients with an inclination toward open mouth posture may intentionally keep their mouth closed during assessment if they are aware they are being evaluated. Effective chairside assessment for potential OMDs consists of extraoral observations and intraoral findings. To attain the most accurate observation during extraoral assessment, the patient's lips should be in a relaxed position and not pursed or straining to gain closure. Clinicians should take note if the tongue is placed between the teeth and listen for unclear "slushy" sounds when patients are speaking. 35 During intraoral assessment, malocclusion, ankyloglossia, current or former oral habits, and palate shape should be noted. Clinicians must be aware that although malocclusion may appear to have been corrected through orthodontics, signs from the extraoral assessment may indicate a possible orthodontic relapse.

Conclusion

OMDs and chronic oral dysfunction can lead to dental malocclusion and related craniofacial dysmorphology. Understanding the underlying pathologies that contribute to malocclusion is vital in achieving long-term facial stability. The goal of orofacial myofunctional therapy is to establish optimal functional relationships between the orofacial muscle complex, temporomandibular joint, myofascial connective tissues, and associated neurological systems, resulting in a balanced, stable, and pain-free homeostatic environment. ⁴ Early detection of OMDs and malocclusion by oral health professionals is imperative in supporting this goal, as thorough assessment and proper diagnosis precede effective treatment.

References

1. Mason R. A retrospective and prospective view of orofacial myology. International Journal of Orofacial Myology and Myofunctional Therapy. 2005;31(1):5-14.

2. Washington S, Ray J. Orofacial myofunctional assessments in adults with malocclusion: a scoping review. International Journal of Orofacial Myology and Myofunctional Therapy. 2021;47(1):22-31.

3. Saccomanno S, Paskay L. New ˇ rends in Myofunctional Therapy. 2nd ed. Milano, Italy: Edi.Ermes; 2020.

4. Benkert K. The effectiveness of orofacial myofunctional therapy in improving dental occlusion. International Journal of Orofacial Myology and Myofunctional Therapy. 1997;23(1):35-46.

5. Farrell C, Darcy M. The history of myofunctional orthodontics. Available at: myoresearch.com/​storage/​app/​media/​history-of-myofunctional-orthodontics-part-I-0518.pdf. Accessed June 6, 2022.

6. Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital. 2016;36:386-394.

7. Assaf DDC, Knorst JK, Busanello-Stella AR, et al. Association between malocclusion, tongue position and speech distortion in mixed-dentition schoolchildren: an epidemiological study. J Appl Oral Sci. 2021;29:20201005.

8. Lombardo G, Vena F, Negri P, et al. Worldwide prevalence of malocclusion in the different stages of dentition: a systematic review and meta-analysis. Eur J Paediatr Dent. 2020;21:115-122.

9. da Fontoura C. The interconnection between malocclusion and mouth breathing. Global Journal of Otolaryngology. 2021;24:5.

10. Valcheva Z, Arnautska H, Dimova M, Ivanova G, Atanasova I. The role of mouth breathing on dentition development and formation. Journal of IMAB-annual proceeding (scientific papers). Available at: journal-imab-bg.org/​issues-2018/​issue1/​vol24issue1p1878-1882.html. Accessed June 6, 2022.

11. Archambault N. Healthy breathing, 'round the clock. Available at: https:/​/​leader.pubs.asha.org/​doi/葖.1044/​leader.FTR1.23022018.48. Accessed June 6, 2022.

12. Wysocki J, Krasny M, Skarżyński P. Patency of nasopharynx and a cephalometric image in the children with orthodontic problems. Int J Pediatr Otorhinolaryngol. 2009;73:1803-1809.

13. Mew JR. The postural basis of malocclusion: a philosophical overview. Am J Orthod Dentofacial Orthop. 2004;126:729-738.

14. Buschang P, Jacob H, Carrillo R. The morphological characteristics, growth, and etiology of the hyperdivergent phenotype. Semin Orthod. 2013;19:212-226.

15. Brinkman-Falter P. Myofunctional therapy: enhancing your dental hygiene career. Available at: pubs.royle.com/​publication/​frame.php?i=654602&p=&pn=&ver=html5&view=articleBrowser&article_​id=3631353. Accessed June 4, 2021.

16. Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am. 2008;19:691-707.

17. Neiva F, Wertzner, H. A protocol for oral myofunctional assessment: for application with children. International Journal of Orofacial Myology and Myofunctional Therapy. 1996;22(1):8-19.

18. Garde J, Suryavanshi R, Jawale B, Deshmukh V, Dadhe D, Suryavanshi M. An epidemiological study to know the prevalence of deleterious oral habits among 6 to 12 year old children. J Int Oral Health. 2014;6:39.

19. MacAvoy SK, Jack HC, Kieser J, Farella M. Effect of occlusal vertical dimension on swallowing patterns and perioral electromyographic activity. J Oral Rehabil. 2016;43:481-487.

20. Elad D, Kozlovsky P, Blum O, et al. Biomechanics of milk extraction during breast-feeding. Proc Natl Acad Sci U S A. 2014;111:5230-5235.

21. Pires SC, Giugliani ER, Caramez da Silva F. Influence of the duration of breastfeeding on quality of muscle function during mastication in preschoolers: a cohort study. BMC Public Health. 2012;12:934.

22. Hong P, Lago D, Seargeant J, Pellman L, Magit AE, Pransky SM. Defining ankyloglossia: a case series of anterior and posterior tongue ties. Int J Pediatr Otorhinolaryngol. 2010;74:1003-1006.

23. Guilleminault C, Huseni S, Lo L. A frequent phenotype for paediatric sleep apnoea: short lingual frenulum. ERJ Open Research. 2016;2:00043-2016.

24. Huang Y, Quo S, Berkowski J, Guilleminault C. Short lingual frenulum and obstructive sleep apnea in children. Int J Pediatr Res. 2015;1:003.

25. Baxter R, Merkel-Walsh R, Baxter B, Lashley A, Rendell N. Functional improvements of speech, feeding, and sleep after lingual frenectomy tongue-tie release: a prospective cohort study. Clin Pediatr (Phila). 2020;59:885-892.

26. Zaghi S, Valcu-Pinkerton S, Jabara M, et al. Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases. Laryngoscope Investig Otolaryngol. 2019;4:489-496.

27. Bussi MT, Corrêa C de C, Cassettari AJ, et al. Is ankyloglossia associated with obstructive sleep apnea? Braz J Otorhinolaryngol. 2021;S1808-8694:181-186.

28. García Pola MJ, González García M, García Martín JM, Gallas M, Seoane Lestón J. A study of pathology associated with short lingual frenum. ASDC J Dent Child. 2002;69:59-62.

29. Wildenberg JC, Tyler ME, Danilov YP, Kaczmarek KA, Meyerand ME. Altered connectivity of the balance processing network after tongue stimulation in balance-impaired individuals. Brain Connect. 2013;3:87-97.

30. Hirano Y, Onozuka M. [Chewing and cognitive function]. Brain Nerve. 2014;66:25-32.

31. Miles TS, Flavel SC, Nordstrom MA. Stretch reflexes in the human masticatory muscles: a brief review and a new functional role. Hum Mov Sci. 2004;23:337-349.

32. D'Onofrio L. Oral dysfunction as a cause of malocclusion. Orthod Craniofac Res. 2019;22(Suppl 1):43-48.

33. Becht MP, Mah J, Martin C, et al. Evaluation of masseter muscle morphology in different types of malocclusions using cone beam computed tomography. Int Orthod. 2014;12:32-48.

34. Hsu HY, Yamachuchi K. Decreased chewing activity during mouth breathing. J Oral Rehabil. 2012;39:559-567.

35. Grandi D. The "interdisciplinary orofacial examination protocol for children and adolescents": a resource for the interdisciplinary assessment of the stomatognatic system. International Journal of Orofacial Myology and Myofunctional Therapy. 2012;38:15䎮.

From Dimensions of Dental Hygiene. July 2022; 20(7)36-39.

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The Impact of Orofacial Myofunction Disorders on Malocclusion - Dimensions of Dental Hygiene | Magazine

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Dimensions of Dental Hygiene is a monthly, peer-reviewed journal that reconnects practicing dental hygienists with the nation's leading educators and researchers. Dimensions is committed to the highest standards of professionalism, accuracy, and integrity in our mission of education supporting oral health professionals and those allied with the dental industry.

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This study evaluates the quality of life in children with skeletal malocclusion, which is the misalignment of the teeth and jaws after undergoing myofunctional therapy, a type of treatment that focuses on correcting improper muscle function around the mouth. This article supports this technology and provides a various amounts of advantages. The researchers in this article conducted a questionnaire-based study, gathering responses from parents and caregivers to assess various aspects of the children's physical and emotional well-being before and after therapy. The results and advantages of this therapy showed that myofunctional therapy improved not only the children’s dental alignment but also their overall quality of life, including their self-esteem, facial appearance, and ability to function in daily activities. The study suggests that myofunctional therapy can be a beneficial non-invasive approach for managing skeletal malocclusion in children. Disadvantages found within this article consist of limited efficacy for the severe cases, need for compliance and motivation of the patient, time-consuming, and lack of immediate results.

Does not specify the exact cost within this article. And it is best to consult directly with clinics that provide these services.

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ORAL CANCER SCREENING DEVICES ARTICLE #1

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ORAL CANCER SCREENING DEVICES ARTICLE #1

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This article talks about the use of OralID, a device that helps aid in the detection of oral cancer. The authors highlight its role in improving the accuracy of diagnosing precancerous or cancerous changes in the mouth. By the use of this technology, a healthcare provider can better identify abnormal tissues. The advantages of this technology is that it helps to lead to earlier detection of cancer, improved accuracy, cost-effective, non-invasive, and reduced procedure time. The disadvantages listed in this article include cost of equipment, training requirements, false positives/negatives, and technological limitations. This study overall emphasizes the importance of combining advanced technology with traditional biopsy methods to enhance diagnosis and patient outcomes.

Cost is not specified within this article.

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ORAL CANCER SCREENING DEVICES ARTICLE #2

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ORAL CANCER SCREENING DEVICES ARTICLE #2

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The article discusses the development of a low-cost, portable screening system designed for the early detection of oral cancer. This technology provides dental personnel and healthcare providers a different diagnostic methods to improve the accuracy of detecting oral cancer at an early stage. The advantage of this technology is to have the resources more accessible, especially in low-resource settings, helping to catch the disease earlier when treatment is more effective. Along with it being easy to use, cost-effective, and capable of reaching underserved populations, thereby improving oral cancer outcomes.

Disadvantages consist of limited scope of detection, training requirements, and limited sensitivity/specificity.

Cost is not specified within this article.

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ORAL CANCER SCREENING DEVICES ARTICLE #3

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ORAL CANCER SCREENING DEVICES ARTICLE #3

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The article explores the effectiveness of tissue autofluorescence imaging in detecting oral mucosal lesions. VELscope is a non-invasive tool that uses natural tissue fluorescence to highlight abnormal tissue, making it easier for clinicians to spot potentially cancerous or precancerous lesions in the mouth. The study found advantages of enhancing the ability to visualize these lesions, offering a valuable aid for early detection of oral cancer, ease of use, and its non-invasive nature. Disadvantages of this technology is the dependence on the operator's skill, false positives/negatives, and limited ability to identify all types of lesions. This overall article talks about the technology effectiveness in improving accurate diagnosis, allowing for earlier intervention and better patient outcomes.

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Oral irrigation is a cleaning method that uses a stream of water or antimicrobial solution to remove plaque and food particles from between the teeth and along the gumline. This review found the advantages of adding oral irrigation to regular tooth brushing helps reduce plaque and improve gum health, reduce gum inflammation and improve clinical signs of periodontal disease more effectively than brushing alone. Disadvantages listed within this article consist of limited effectiveness in severe periodontal disease, technique-sensitivity and cost/accessibility.

Cost is not specified in this article.

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This study tested the effect of adding oral irrigation to regular oral care for managing peri-implant mucositis, a condition where the gums around dental implants become inflamed. In a randomized controlled trial, they found that using oral irrigation in addition to self-care (like brushing) helped reduce gum inflammation and improved oral hygiene in patients with peri-implant mucositis. This suggests that oral irrigation can be a beneficial tool for managing this condition. Advantages consist of improved gum health, enhanced plaque removal, non-invasive and easy to use.

Disadvantages of technique sensitivity, requirement of consistency, and possible irritation.

cost is not specified within this article.

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This randomized clinical trial evaluated the effectiveness of combining tooth brushing with oral irrigation to maintain the hygiene of dental implants and overdentures. The study found advantages of using oral irrigation in addition to regular brushing. It was found to improve plaque control and gum health around both implants and overdentures. Participants who used both methods showed better oral hygiene outcomes, including reduced plaque and less gum inflammation, compared to those who only brushed. The study suggests that combining brushing with oral irrigation can be an effective strategy for maintaining oral health in patients with implants and overdentures. Disadvantages consisted of possible discomfort, technique sensitivity, and time and effort it takes.

Cost is not specified within this article.

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The article reviews how teledentistry and mobile health technologies can improve oral health promotion and prevention. Teledentistry is described in this article as using digital technologies to provide dental care and consultations remotely. This article supports the use of this technology. It finds that these tools have the advantages of enhancing access to dental care, educating patients, and supporting preventive measures, especially in remote areas. The study highlights the potential of teledentistry and mHealth to improve oral health outcomes in a cost-effective and accessible way. The disadvantages listed in this article consist of limited physical examination, technical barriers, privacy/security concerns, and limited scope of complex cases.

Cost is not specified within this article but is stated that it can be a cost-effective solution for promoting dental health.

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The article discusses a survey by the American Dental Association on teledentistry adoption. Teledentistry is described as the use of digital technology to provide remote dental consultations, education, and follow-up care. This article supports the use of teledentistry but provides both limitations and advantages of these uses. It finds that while teledentistry is growing, its use varies across practices. Dentists express benefits/advantages in consultations and patient education but face barriers or disadvantages of reimbursement concerns, technology costs, and legal issues. Despite these challenges, teledentistry holds promise for improving access to dental care, particularly in underserved areas.

Cost is not specified within this article.

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The article explains how teledentistry became crucial during the pandemic by allowing remote consultations and care while minimizing in-person visits. This article supports the use of this technology. Teledentistry is described as the use of digital technology to provide remote dental consultations, care, and advice. It highlights the advantages of the use of this technology like increased access to dental care and convenience but also mentions challenges or disadvantages such as limited patient familiarity with technology and regulatory issues.

Cost is not specified within this article.

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The article explores a clinical trial comparing traditional periodontal therapy with treatment using a periodontal endoscope. It supports the use of this technology. In the article, the periodontal endoscope is described as a small, specialized tool that provides enhanced visualization of periodontal tissues during nonsurgical periodontal therapy. It allows dental professionals to more precisely examine and treat areas that are difficult to see with the naked eye, which helps to improve the effectiveness of the procedure and managing periodontal disease. Disadvantages consist of increased time consumption, cost, learning curve, and limited accessibility.

Cost is not specified within this article but mentions the potential for high initial investment and overall maintenance costs associated with this new technology.

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The article evaluates the effectiveness of subgingival scaling and root planing with and without the use of a periodontal endoscope. This article supports this technology and describes it as a small, specialized instrument that provides enhanced visualization of subgingival tissues during periodontal procedures. It compares the outcomes of traditional SRP versus SRP enhanced by the endoscope, which offers better visualization of the periodontal tissues. The study finds that using the periodontal endoscope has advantages when compared to not using the tool, it helps with the precision of treatment and may lead to better clinical results in managing periodontal disease. Disadvantages of this technology consists of increased procedure time, cost, technological challenges and limited accessibility.

Cost is not specified within this article but talks about the initial investment may be on the spendy side.

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Journal of Periodontology - 2007 - Geisinger - The Effectiveness of Subgingival Scaling and Root Planing  An Evaluation of

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The article reviews clinical trials on the use of a periodontal endoscope during subgingival debridement for treating periodontitis. This article supports the use of this technology. It finds that the endoscope improves precision and has many advantages by allowing better visualization, potentially leading to more effective treatment. Advantages consist of improved visualization, increased precision, enhanced treatment outcomes, and minimized tissue damage. Disadvantages consist of increased procedure time, cost, technical issues, and limited accessibility.

Cost is not specified within this article.

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COST: $1,695-$1,995

COST PER PATIENT: $1.96 per screening

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VELscope® - Award-Winning Oral Screening and Imaging Technology

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By Wayne Rees

How Much Does the VELscope Cost?

The VELscope Vx system is one of the leading technologies for the adjunctive visualization of oral mucosal abnormalities, including dysplasia, oral cancer, infections and trauma. Any dentist considering adding an oral screening device to their practice will typically research the available technologies and inevitable come to the question of cost. While the VELscope's cost is pretty straightforward, there are some considerations worth discussing, which I will outline in this article. Please note, the VELscope is sold via a network of distributors that may offer incentives or special discounts, so the numbers discussed here will be our manufacturer's suggested retail price (MSRP).

Cost of The VELscope Vx

The VELscope Vx is offered in two packages: a standard unit and a value bundle. While the standard VELscope system offers everything you need to get started screening your patients, the Value Bundle provides a few additional options that many practices want to take advantage of.

Cost of the Standard VELscope Vx

The standard VELscope Vx system is $1,995 and includes:

VELscope Vx handpiece/charger

Patient safety glasses

Samples of VELcap and VELsheath disposables

Patient brochures

Oral Cancer Foundation brochures

On-Demand training modules

The standard VELscope package is the most affordable way to purchase the VELscope Vx system from an upfront investment perspective.

Cost of the VELscope Vx Value Bundle

The VELscope Vx Value Bundle includes a few additional options beyond the standard package. The VELscope Vx Value Bundle is $2,495 and includes:

VELscope Vx handpiece/ charger

(128) VELcap Vx disposables

(250) VELSheath Vx disposables

VELscope Vx Imaging Adapter and 7th Generation iPod touch for photo documentation

Patient brochures

Oral Cancer Foundation brochures

Waiting room posters

On-Demand training modules

The key differences in the standard VELscope Vx package and the Value Bundle are the iPod photo documentation system and the amount of disposables included.

Per Patient Cost

As with any medical or dental device, infection control and preventing cross contamination are critical to safeguarding the health of your patients. The VELscope Vx requires the use of disposable asepsis barriers for every examination. The VELcap Vx covers the lights and optics that are positioned near the patient's mouth during screening while the VELsheath covers the system handle. While not every oral screening technology requires an asepsis barrier, we feel this is an important part of the overall approach to patient screening. Here is a breakdown of the cost of VELscope disposables:

VELcaps - $230.40/box or $1.80 per patient

VELsheath - 39.95/box or $.16 per patient

Total - $1.96 per patient exam

Annual Support

There is no additional cost for technical assistance for the VELscope Vx system, so you will not pay any monthly support fees. The VELscope Vx is covered by a one-year manufacturer's warranty at the time of purchase. VELcare Product Protection is available at the beginning of your second year of VELscope ownership and extends the manufacturer's warranty annually against defects with additional coverage against accidental damage. Here is a breakdown of VELcare cost and benefits:

$395 per year for initial unit

$205 per year for each additional unit

1-year of extended warranty coverage:

Battery

Eyepiece

Power Supply

Power Cord

Charging Cradle

iPod touch adapter, parts and accessories

Includes standard shipping (inbound and outbound)

Return on Investment

We are often asked about the return on investment when discussing the VELscope. Typically, we recommend practices charge anywhere from $15-$20 per patient for a VELscope exam. If a practice scans 4 patients per day, 4 days per week, the VELscope pays for itself within two months. We also stress to our customers that the patient's ability to pay should not be a barrier to oral cancer screening - we feel screening for oral cancer is that important. Screenings with the VELscope are reimbursable under some insurance plans but we still recommend setting your per patient exam fee at a very affordable out of pocket price point to encourage acceptance of the screening.

So How Much Does the VELscope Cost?

You can anticipate an up-front investment in the VELscope will cost around $1,695-$1,995. The additional cost per patient will be around $1.96 per screening. Again, these are manufacturer's suggested prices and our distributors set the actual sale price.

In full transparency, the VELscope is not the least expensive oral screening technology on the market, so if you are extremely cost-conscious, the VELscope may not be the best fit for your practice. Ultimately, we recommend that all practices do their research into all oral screening technologies, comparing cost, efficacy of the device and a review of clinical research studies to determine which oral screening technology is the best fit for your practice.

As always, we are happy to answer any questions you have and can connect you with a VELscope dealer. Please click the button below or call 877.278.3799.

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How Much Does the VELscope Cost? - VELscope®

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By Wayne Rees How Much Does the VELscope Cost? The VELscope Vx system is one of the leading technologies for the adjunctive visualization of oral mucosal abnormalities, including dysplasia, oral cancer, infections and trauma.

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COST: $50-130

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Shop Countertop & Cordless Water Flossers

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Waterpik™ water flosser products are known for innovation, performance, and quality, with options and advanced features to fit any need or lifestyle.

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Cost: varies based on the website patients go through

Teledentistry (listed above): $50

Sesame: $75-80

DentalChat: $29-49

The TeleDentists: $59 (second appt/opinions: $199)

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Multiple insurance companies work with us to ensure consultations with our live dentists are a covered expense. The price for a consultation is a covered service.

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Equipment cost: $2,500-3,000

Sheaths: $50 each (non-reusable)

Fibers: $1,400 (last 50-70 uses)

Explorers: $85 each