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Tag: dentists

  • Have money, will travel: a16z’s hunt for the next European unicorn | TechCrunch

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    Gabriel Vasquez, a partner at Andreessen Horowitz, recently revealed he took nine flights from NYC to Stockholm in one year. While his visits included stops at companies like Lovable — where he posted from its office — the trips were also about finding future Swedish unicorns before they cross the Atlantic.

    This all came to light when news emerged that a16z had led a $2.3 million pre-seed round into Dentio, a Swedish startup that uses AI to help dentists’ practices with admin work. While this is a small check for a firm that just announced new funds totaling $15 billion, it confirms that U.S. VCs are actively seeking deal flow outside of the U.S., even without local offices.

    Stockholm is a natural stop for a16z, which previously achieved significant returns from backing Skype, cofounded by Swedish entrepreneur Niklas Zennström. Since then, a significant number of fast-growing startups have been created in the Swedish capital, and the VC heavyweight tracked down where many of them were coming from. 

    “We spend a lot of time developing a deep understanding of specific markets and knowing where innovation is emerging. In Sweden, that has meant closely tracking ecosystems like [SSE Business Lab] — the startup incubator of the Stockholm School of Economics — and the companies coming out of it,” Vasquez told TechCrunch.

    Like fintech giant Klarna, legal AI startup Legora, and e-scooter company Voi, Dentio is an alum of SSE Business Lab — a startup incubator that has produced several successful Swedish companies. The three former high school classmates Elias Afrasiabi, Anton Li and Lukas Sjögren joined the incubator after reconnecting as students at both the SSE (Stockholm School of Economics) and KTH (Royal Institute of Technology), then joined the incubator with additional backing from KTH’s Innovation Launch program. They tackled a problem close to home: Li’s mom, a dentist, had told them how admin work detracted from clinical care.

    The trio intuited that they could leverage LLMs to help people like her — an idea that they also validated with her and her colleagues. This led them to Dentio’s initial product, a recording tool that uses AI to generate clinical notes. But it’s only a matter of time before AI scribes become a commodity product, and Dentio needs to prove its value to dentists so they aren’t tempted to switch providers when that happens, Afrasiabi said.

    Potential competitors include fellow Swedish startup Tandem Health, which raised a $50 million Series A round last year to support clinicians with AI across multiple medical specialties. Dentio, by contrast, focuses exclusively on dentists, but it believes it can still reach the scale VCs expect through international expansion

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    “Now we’re a team of seven people, and we think that it’s possible to build a unified way of handling administration all over Europe, and maybe even all over the world,” Afrasiabi said. While Europe’s healthcare systems are fragmented, they share similarities, and Dentio’s assumption is that what works in Sweden could work elsewhere in the EU.

    Dentio prominently features its “Made in Sweden” branding and emphasizes that “all relevant data is processed in Sweden and Finland in compliance with Swedish and EU law.” It signals data protection to privacy-conscious European customers. But it also signals potential to VCs — a callback to Sweden’s history of producing breakout companies.

    “We went to zero meetups. I reached out to zero investors,” Afrasiabi said. While the team was heads down building, the word spread out. “I think it was mostly through referrals and people talking to each other that the news got all the way over to the U.S.,” he said.

    This wasn’t happenstance: a16z has eyes around the world in order to spot these companies as early as local funds might, Vasquez said. “In Sweden for example, we partnered with top founders abroad like Fredrik Hjelm, founder of Voi, and Johannes Schildt, founder of Kry, by turning them into scouts and mapping the best local talent.”

    For Vasquez, who focuses on AI application investments for a16z, this isn’t just about Sweden, but about “a pattern of great global companies being born abroad and scaling quickly,” from Black Forest Labs in Germany to Manus, the Singapore-based AI startup recently acquired by Meta.

    Born and raised in El Salvador, he has also been spending time in São Paulo. “I’m really excited about what’s brewing in Brazil and across Latin America in AI,” he wrote on LinkedIn at the time. “I believe AI is the great equalizer,” he added. “Most people now have access to PhD-level intelligence on a phone, and ultimately, Silicon Valley is a state of mind.”

    Corrections: This story originally stated that a16z is an investor in Lovable owing to an editing error. The name of SSE’s incubator has also been corrected.

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    Anna Heim

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  • Denver-area dentists are upselling invasive cleanings, PDS Health patients allege

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    When a dentist at Lakewood Modern Dentistry told Hailey Hernandez she needed a deep cleaning, a root canal and a crown to treat extensive gum disease and other problems, alarm bells went off in her head.

    “I knew that I was taking care of my teeth and there’s no way I have gum disease,” she said.

    Her old dentist in Arizona said she was right when she went back for a second opinion, the Golden resident said. Her suspicions rose further when two friends told her they also received gum disease diagnoses from Lakewood Modern Dentistry and were told they’d need deep cleanings, root canals and crowns.

    “There’s no way,” she said. “It just does not sound right at all.”

    One of those friends, Avery Huffer, said she, too, had been surprised to hear she needed such extensive treatment, but went forward with it. When she returned about a year later, the Englewood resident learned she’d need deep cleanings every three months, plus more root canals and crowns — on teeth that weren’t the ones giving her pain.

    Huffer said she decided not to undergo the additional treatment after speaking with coworkers who were told they needed the same procedure.

    “Is that just their baseline diagnosis?” Huffer said she wondered.

    Lakewood Modern Dentistry is one of more than 50 offices in the Denver area affiliated with PDS Health, a Nevada-based practice-management company working with dentists in 16 states. While each practice has independent ownership, they have nearly identical websites, with the same broad-smiling woman on the home page and the same pitch for financing up to $75,000 in dental work, subject to credit approval.

    The majority of the practices also share a perception among some former patients that dentists and staff exaggerated their oral health problems and recommended unnecessarily invasive treatments. Of the 53 affiliated practices in the Denver area, 40 had online reviews in the last three years alleging their dentists had told patients they needed extensive work, such as deep cleanings or root canals, when they believed a less-invasive alternative would suffice.

    The Denver Post spoke to six patients, including Hernandez and Huffer, who said PDS-affiliated practices pushed them to pay out-of-pocket for deep cleanings and other invasive work they believe they didn’t need. The five who sought second opinions said they were told their mouths were largely healthy.

    While the patients who spoke to The Post believed their dentists were upselling them to make more money, the lack of standardization in dentistry creates challenges in trying to parse why two providers might have dramatically different recommendations, experts said.

    With no clear professional standards and limited pushback from insurers on unnecessary procedures, patients are largely on their own to sort out if a practice is upselling them, said Beth Mertz, a professor at the University of California, San Francisco’s School of Dentistry. They should get a second opinion if a diagnosis and treatment plan seem off, she said.

    “Dentistry is still the Wild West,” she said. “The whole system is not set up to serve the public particularly well.”

    PDS Health spokeswoman Ellen Driscoll said the company provides non-clinical support services to independent dental offices, whose owners make treatment decisions based on their patients’ needs. Dentists have a long-standing debate about how best to treat gum disease, which is common and underdiagnosed, she said.

    Lakewood Modern Dentistry said it uses advanced technology to detect gum disease early, catching problems other dentists might miss.

    “Periodontal disease is both widespread and often missed in its early stages,” the practice said in a statement. “Our team follows national clinical standards and is committed to preventive care.”

    Dentists can have good-faith differences of opinion about how aggressively they should manage common conditions such as gum disease, which can cause inflammation that leads to other health problems, said Dr. Brett Kessler, former president of the American Dental Association. Patients need to find a provider whose views are a match for theirs, he said.

    “How the patient is treated depends on the patient’s goals and the provider’s philosophy, and how they weigh together,” he said.

    Differences in philosophy and training explain some of the gap in what dentists recommend, but the profit motive is a factor, too, Mertz said. “Secret shopper” studies have shown dentists give radically different recommendations if a person’s dress and demeanor signal they can afford expensive care, she said.

    “Because dental insurance pays more based on what you do, providers are incentivized to do more,” she said.

    Pricey deep-gum cleaning

    Most dental insurance covers two routine cleanings each year, though plans vary in how much they contribute toward deep cleaning and other treatment.

    Michael Gitomer, of Denver, said the finance person at Edgewater Modern Dentistry and Orthodontics told him he would have to pay $1,000 to $1,500 out-of-pocket for deep cleaning and a crown.

    Deep-gum cleaning, also known as scaling and root planing, involves removing plaque beneath the gum line in the same way that dental hygienists scrape it off the visible part of the tooth during a routine cleaning. In some cases, dentists also give antibiotics to help root out bacteria that cause gum disease.

    Gitomer had expected only a $30 co-pay that day, so he asked for a routine cleaning while he considered his options.

    “They were refusing to give me a regular cleaning unless I paid for all these other things,” he said, though they relented after he “gave them a pretty hard time about it.”

    His previous dentist didn’t see any need for invasive work, but recommended flossing more often.

    Edgewater Modern Dentistry said it strives to earn patients’ trust through “clear communication and honest assessments.”

    “Periodontal disease often advances without pain, which is why we focus on early identification and informed care. Our clinicians are here to listen, explain, and help patients make confident decisions about their oral health,” the practice said in a statement.

    Duke Harten, of Denver, said he had a similar experience at City Park Dental Group and Orthodontics: The dentist told him he had serious gum disease and needed deep cleanings every three months, which his insurance wouldn’t cover. He was suspicious because his previous dentist never identified any problems, and he looked up the office’s reviews, which seemed to suggest a pattern.

    A dentist he saw for a second opinion said his gums were healthy, Harten said, and even his records at City Park Dental seemed to contradict the idea that he needed extensive care, saying he had “good oral hygiene” and “no problems noted.”

    City Park Dental said in a statement that it is committed to clear communication with patients and adheres to best practices for treatment.

    “When it comes to conditions like periodontal disease, timing and technology can affect what a provider sees, and how they choose to respond. While care approaches may vary between dentists, our goal is always the same: to help patients stay ahead of disease and maintain their long-term health,” the practice’s statement said.

    ‘They said I needed all this work’

    Samantha Nuyen, of Denver, said Highlands Dentists didn’t identify any problems with her mouth on her first two visits, but told her she had multiple cracked teeth on the third. The dentist she saw for a second opinion didn’t find any cracks or other major concerns, she said.

    When she told her provider at Highlands Dentists about the second opinion, they didn’t offer any explanation for the discrepancy or defend their recommendation, Nuyen said.

    “They said I needed all this work that I didn’t need,” she said.

    Highlands Dentists said oral health is deeply connected to the rest of the body’s well-being and it is treated early to prevent bigger problems.

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    Meg Wingerter

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  • One-third of Gov. Jared Polis’ budget cuts involve Medicaid

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    Almost one-third of the budget cuts and sweeps of unused money that Gov. Jared Polis used to close a $249 million budget hole will come from Medicaid, and providers are trying to figure out how much disruption that will cause for them and their patients.

    H.R. 1, known as the “Big Beautiful Bill,” blew a roughly $783 million hole in the state budget in July, because Colorado’s tax laws automatically adjust to stay in harmony with the federal government’s. The legislature opted to undo some of those changes during a special session in August and gave Polis the authority to fill the rest of the gap.

    About $79.2 million of the $252 million in cuts came from the Colorado Department of Health Care Policy and Financing, which runs Medicaid in the state. The list includes a mix of reductions in the rates paid to people who provide care, unused funds swept from specific programs and plans to review some care types more strictly before paying.

    The largest cut, worth roughly $38.3 million, would roll back most of a 1.6% increase that most providers expected to get this year. Since providers received slightly higher rates in the first months of the fiscal year, it will work out to about a 0.4% increase, which is in line with recent years, the department said.

    Denver Health estimated the rollback would cost the city’s safety-net hospital about $5 million. The health system isn’t planning any layoffs or service reductions, but could cut back on nonessential maintenance and technology updates, CEO Donna Lynne said. As it was, the increase only partially offset growth in costs in recent years, she said.

    “We were already trying to absorb the difference between medical inflation and the 1.6%,” she said. The American Hospital Association estimated hospital costs rose about 5.1% in 2024.

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    Meg Wingerter

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  • The glories of Mexican dentistry

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    This is part of Reason‘s 2025 summer travel issue. Click here to read the rest of the issue.

    I crossed the U.S./Mexico border six times in a month in 2018, an economic refugee in my own way.

    While the consumer price index indicates an overall U.S. inflation rate of around 85 percent since 2000, over that same period inflation in dental costs was more like 133 percent, according to the Bureau of Labor Statistics.

    I needed some extensive and expensive dental work, and so I crossed borders seeking my own version of a better (in my case, more affordable) life, sometimes under the piercing gaze of the federales. I occasionally drove through U.S. border inspection, many dozens of miles from the border on Interstate 8, being ordered via signs to come to a stop while an agent glanced at my car without actually engaging me in any conversation or even making me turn off the vehicle.

    Mexico could not have cared less about this border crossing back then; no one asked for your papers, por favor, as you strolled unimpeded from the parking lot on the U.S. side and entered Algodones from Winterhaven, California, at the Andrade border crossing. According to my Mexican dentist, nearly 13,000 tourists enter there on an average winter day. Algodones is a dental and optical retail paradise; the three blocks I walked to my dental destination were all storefronts selling those services, along with some pharmacies.

    Reentering the U.S., however, required standing in a line that was always 45–60 minutes long. At the end you had to show a bored customs officer a passport and answer questions about what you had bought in Mexico. Such answers, at least from a white dude then in his late 40s, were casually believed. If you were driving a car back, you were likely to have a black-suited police officer walk a big menacing looking grey-black dog by your car as it waited in the long line to return to the land of high dental prices.

    I was a day tourist in Algodones to replace a three-unit dental bridge first installed about 10 years earlier by a Los Angeles dentist. It had become uncemented about four years prior. I had paid American dentists to recement it three times, and finally it just broke and could no longer be reattached.

    Anywhere near where I live in California, getting a new one made and installed would have cost around $5,000 then; I got out for $1,300 in Algodones, a fee (paid in U.S. dollars cash) that covered three visits, a deep cleaning, and a root canal in addition to making and installing the bridge.

    In terms of bedside manner and the general attitude toward patient-doctor relations, I had an experience unlike any I’d had with an American dentist. I was treated in Mexico as a customer, not a ward. If they suggested work more elaborate or pricey than I felt like spending—and they did—the conversation ended with my demurral.

    I’ve had American dentists straight up refuse to do any ameliorative work short of the more thorough and expensive suggestion they repeated to me incessantly to try to break down my resistance while I was sitting prone in their chair. Now, my desires don’t match those of all American patients, who according to some trend watchers in dentistry want more preventative, holistic, and membership-based work. I’m usually looking to solve an immediate issue that I physically perceive as a problem, and to do it with as little rigamarole and cost as I can. It’s great for me, and people like me, that the Algodones option is there. (Even prior to post-COVID inflation, 15 percent of Americans already said that cost kept them from dental care.)

    There was one aspect of the experience I didn’t love. I’m a bit of a radiation hypochondriac, and they were very casual about shielding you with lead bibs when X-raying you; unless you insisted, they would not do it. While I cannot judge on a professional regulatory level, their general hygiene practices otherwise seemed to match those of a typical American dentist, and I certainly never felt any ill effects.

    As far as my needs went, the work seems to be of long-term quality equal to the American work that cost more than four times as much. While I will never know if this is a fault of the Mexican work or an inevitability in any case, the teeth beneath the bridge six years down the line reached a state of rot that led to a gum and sinus infection, or so an American physician believed. So though the bridge was still solidly in place, I had it pulled to extract the husks of teeth underneath it. Nothing is forever. The very fact I had to have this work done in Mexico was because of the lack of permanence of the more than $4,000 bridge I had put in about a decade prior.

    Over all fields, Americans are spending around $4 billion a year on foreign medical care, and that’s likely to grow by about 13 percent a year over the rest of the decade. Dentists themselves are complaining these days that their costs are outgrowing their revenue, and profits and access to hygienists are both being strained. The range of conditions that make dentistry so much more affordable in Mexico include some elements that an American of any income level might not want to be completely enveloped in, such as far lower wages for professionals and their associates, and cheaper overhead from an atmosphere of less prosperity and demand.

    But that’s why it’s good to be able to take advantage of the elements that are better on either side of the border.

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    Brian Doherty

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  • Don’t fall for fake dentists offering veneers and other dental work on social media

    Don’t fall for fake dentists offering veneers and other dental work on social media

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    If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office. Here’s what to know about veneers and how to avoid bogus providers and services: Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced. In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.”Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.” Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.Patients need to be anesthetized before the enamel is removed from their teeth.”It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.”If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers. One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.” Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.Performing dental work without an appropriate license is illegal, the ADA notes. Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license. The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.”It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

    WASHINGTON —

    If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

    But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

    These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

    It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

    On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

    Here’s what to know about veneers and how to avoid bogus providers and services:

    Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

    Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

    Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

    In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

    “Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

    Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

    Patients need to be anesthetized before the enamel is removed from their teeth.

    “It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

    One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

    “If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

    Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

    One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

    Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

    Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

    Performing dental work without an appropriate license is illegal, the ADA notes.

    Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

    Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

    The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

    “It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Maryland hopes to recruit young dentists to workforce shortage areas – WTOP News

    Maryland hopes to recruit young dentists to workforce shortage areas – WTOP News

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    State health officials and dental health advocates say that Baltimore and parts of the Eastern Shore and Western Maryland not only lack dentists, but have other barriers that make it difficult for residents to keep up with their oral health.

    This article was republished with permission from WTOP’s news partners at Maryland Matters. Sign up for Maryland Matters’ free email subscription today.

    Maryland has about 70 dentists per 100,000 residents, according data from the Centers for Disease Control and Prevention in 2020, but that doesn’t mean that they are equally distributed across the state.

    State health officials and dental health advocates say that Baltimore and parts of the Eastern Shore and Western Maryland not only lack dentists, but have other barriers that make it difficult for residents to keep up with their oral health.

    The Maryland Department of Health aims to change that with a new program urging dental students to launch their careers in areas with dental health care shortages.

    The Pathways to Bright Futures program, which launched Wednesday, will educate those students about the dentistry profession in hopes of easing shortage in targeted areas.

    Dr. Nilesh Kalyanaraman, the health department’s deputy secretary for public health services said Wednesday that fixing the workforce shortage “won’t be easy and is not going to happen overnight,” but improving access to dental services will help improve overall health equity in Maryland.

    “When I think about our vision for health equity in Maryland, I see everyone in our state having a fair and just opportunity to be as healthy as possible. It’s going to take hard work … to ensure that health equity includes healthy mouths, teeth and gums for all Marylanders,” he said.

    Dr. Debony Hughes, director of the department’s Office of Oral Health, said that many areas in  Western Maryland, the Eastern Shore and Baltimore have fewer than 20 dentists per 100,000 residents, well below the national average of 61 dentists per 100,000 residents.

    “This program is a collaborative effort to work with students and foster their interests in the oral health field and provide support to those who know they want to practice in the profession,” Hughes said Wednesday during the program kickoff at the Dr. Samuel D. Harris National Museum of Dentistry in Baltimore

    Pathways to Bright Futures is funded by a grant to the state from the federal Health Resources and Service Administration. At Wednesday’s event, six dental health students were awarded funds to help pay their dental school tuition.Each of the students plan to practice dentistry in one of the state’s dental shortage areas.

    “Cavities in children and adults, and gum disease especially in adults, are among the most prevalent chronic diseases in the United States,”  Kalyanaraman said. “The main reason why oral disease is so prevalent is that far too many Marylanders experience barriers to preventative and essential dental care.”

    He noted that when Maryland dentists set up their practice, they tend to gather in “more populated and higher income areas, creating significant gaps in access to dental care across other regions of the state.”

    “This shortage creates an uneven distribution of dental professionals across the state, which leads to decreased access to dental care, especially in already underserved communities,” Kalyanaraman said.

    Dr. George Shepley, a general dentist in Baltimore since 1978 who previously served as president of the American Dental Association, said dental care can help identify other health needs.

    “They’re connected. Totally. Especially with things like diabetes and cardiac disease,” Shepley said Wednesday. “And in the world of dentistry, you’ll get insight into well-being overall. You’ll help diagnose other conditions and empower people to really take responsibility for their lives.”

    Mary Backley, CEO of the Maryland Dental Action Coalition, said there are a multitude of logistical and economic barriers that can make it challenging for some Marylanders to get to a dental appointment.

    Besides a lack of equal access to the state’s 4,300 registered dentists,  another issue in dentist shortage areas is transportation, particularly for the more rural communities in Western Maryland and on the Eastern Shore.

    “The biggest barriers, rural-wise, is the distance … It can take miles and miles and miles to get to a provider,” Backley said after Wednesday’s event.

    Baltimore residents are more likely to be face a long waitlist to get a dental appointment, according to Backley. And both rural and city residents may struggle to afford child care or take time off work to go to the dentist in the first place.

    There are also financial hurdles that make it harder for families to afford a trip to the dentist.

    As of January 2023, Medicaid in Maryland began to cover certain dental services for adults.  And the General Assembly this year passed legislation to study the feasibility of including full and partial dentures under Medicaid coverage. Gov. Wes Moore (D) signed the bill in May.

    The state Medicaid expansions can help many low-income families receive dental health care, so long as they have access to a provider that accepts Medicaid. Not all dentists in Maryland do.

    Backley hopes that the Pathways to Bright Futures program will encourage more young people to look to dentistry as a career path and help fill in some of the coverage gaps in the state.

    On the bright side, Backley said that residents and Maryland health officials are taking dental health care seriously.

    “It’s been incremental, but each year there has been progress,” she said. “People understand the importance of oral health. And the importance of oral health to overall health.”

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    Ciara Wells

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  • America’s Teeth Grinders Are Turning to Botox

    America’s Teeth Grinders Are Turning to Botox

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    With the pinch of a needle, cosmetic dermatologists such as Michele Green can make forehead wrinkles disappear and deep-furrowed crow’s-feet puff back out like yeasted dough. Botox is totally magic, a little unsettling, and very in demand: Green’s New York City practice has been swamped as Americans seek to give themselves a “post-pandemic” glow-up. But these days, many of her patients aren’t after eternal youth and sex appeal. When Green reviews her schedule for the week each Monday morning, she told me, “I’m just like, Oh my god.” At least a quarter of her Botox appointments are for people with a different motive entirely: They can’t stop clenching their jaw and grinding their teeth.

    Across the country, patients dealing with the meddlesome condition are now turning to Botox—yes, Botox.  “It’s a very popular treatment” for people who grind and clench their teeth, Lauren Goodman, a L.A.-based cosmetic nurse, told me. Bruxism, the official term encompassing both behaviors, is an involuntary action that tends to happen when people are sleeping at night, for reasons including alcohol and tobacco use, sleep apnea, and stress—perhaps why the condition has soared in the United States during the pandemic. The condition is a tolerable nuisance for many people, but the symptoms can get very real: With bruxism on the rise, dentists are reporting more chipped and cracked teeth in patients, along with jaw pain and facial soreness. In the most severe cases, patients can suffer debilitating headaches and jaw dislocation. The most common treatments, such as mouth guards and lifestyle changes, only sometimes help get rid of symptoms.

    That’s what makes Botox so appealing for the recent flood of teeth grinders. Jaw injections relax the chewing muscles that clench and grind with up to 250 pounds of force—potentially relieving pain and preventing dental issues in the process. It’s not as though every teeth grinder in America is hotfooting it to their nearest Botox clinic, but the procedure seems to have blown up since the start of the pandemic. Five dentists and cosmetic experts told me they’d noticed an increase in teeth grinders and clenchers getting Botox. People who have exhausted more traditional routes are “really just committed to alleviating their pain,” said Samantha Rawdin, a prosthodontist in New York City. “If that means getting a needle to the face, so be it.”

    But even if Botox has some upsides, it’s hardly the permanent, sure-thing solution that dentists and patients have long searched for. That’s been the narrative all along with bruxism: Because there are so many possible causes, treatments are an educated dice roll—and none of them is universally effective. “I don’t tell my patients I can treat them,” Gilles Lavigne, a dentistry professor at the University of Montreal, told me. “I tell them I can help them manage their condition.” So, how do we still not always know how to handle this incredibly common ailment?

    Botox has been creeping onto the teeth-grinding stage since long before the pandemic. Although it has gained noticeable traction over the past few years, research on the efficacy of Botox stretches back to the late 1990s. In the years since, researchers have also discovered that the injections, which temporarily paralyze the masseter muscles responsible for grinding and clenching, can reduce the frequency and intensity of bruxism. It’s one of a slew of non-cosmetic Botox uses that have been identified since the drug hit the market in 1989: Injections also treat issues such as excessive underarm sweating, acne, and migraines.

    Botox for bruxism hasn’t been FDA approved, so it’s still considered off-label—but anyone with a Botox license can legally inject a willing teeth grinder. And at least in theory, Botox has some advantages over other bruxism treatments. Night guards might prevent you from gnashing your teeth into smithereens while you sleep, but they can be ineffective at stopping the behavior and can even make it worse—especially if you have sleep apnea, Jamison Spencer, a dentist and sleep-apnea expert based in Boise, Idaho, told me. Minimally invasive regimes such as yoga, meditation, cognitive behavioral therapy, and physical therapy are hit or miss. Muscle relaxers can be helpful for some patients, but those aren’t universally popular among the dentists I spoke with, some of whom cited America’s opioid crisis as a concern.

    When less invasive treatments don’t work, Botox might be “the next frontier,” Leena Palomo, a professor at New York University’s College of Dentistry, told me. Grinders and clenchers seem to be learning about the injections from a variety of sources. Rita Mizrahi, an oral surgeon in New York who offers Botox for bruxism, told me that her patients are typically referred by their regular dentists. Others discover jaw Botox in online forums such as Reddit and the beauty network RealSelf, where often anonymous discussions of the procedure abound. And some are reading mainstream-media testimonials or hearing about it from friends or family—particularly as more and more Americans embrace Botox for cosmetic purposes.

    At its best, the procedure can really help certain teeth grinders: Studies have indicated that Botox can decrease pain levels. One RealSelf reviewer described trying night guards, stress relief, and cutting out caffeine before getting jaw injections. “Thank goodness for something like Botox to come along in this day and age,” they wrote four months after getting the procedure. The procedure comes with some cosmetic changes too: Grinding and clenching all night can be a workout, which might lead to enlarged chewing muscles and a square, boxy face. The injections slim the jawline for many patients, giving it “more of a V-shape,” Green said.

    But Botox has some real downsides—and plenty of dentists are still hesitant to recommend it. For starters, it’s expensive and impermanent. The procedure typically costs at least $1,000; is not covered by medical or dental insurance; and usually won’t last for more than four months. “This isn’t a onetime thing and you’re good,” Mizrahi said. And like most of the other treatments available, jaw Botox attacks teeth-grinding and clenching symptoms, but not the cause. Because people still need to chew, the masseter muscle isn’t totally immobilized—meaning that patients “will just grind with less power,” Lavigne said.

    And all of the risks associated with the cosmetic use of Botox apply here too, such as bruising at the injection site, headaches, allergic reactions, and less desirable changes in facial expressions due to misplaced Botox. One RealSelf reviewer experienced no improvement in jaw pain but the unfortunate onset of a creepy grin that resembled a “chucky doll smile.” Another said that their headaches disappeared after the procedure, but so did their cheeks: “I couldn’t recognize myself in the mirror and looked like I had aged 10 years within a couple of months.”

    That grinders and clenchers are more frequently turning to Botox is hardly a pure success story. Early mentions of teeth gnashing exist in the Bible, yet we still don’t really understand how to make it stop. I know firsthand how frustrating that feels. In January, after trying (and failing) to open wide enough for a crispy chicken tender, I was finally motivated to see a dentist—who gave me a night guard so I’d quit slamming my teeth together. I meditate like it’s my job, I don’t have sleep apnea or take medications of any sort, and yet I still gnaw on that hunk of plastic like it’s gristle. My jaw doesn’t lock anymore but it’s still tense most mornings. I’m priced out of getting Botox—so, like many teeth grinders, I’m stuck in medical purgatory.

    Teeth grinding isn’t like a broken arm, where cause and effect are obvious and fixable. “Because the origin of [jaw] pain is not singular, you have to attack it from various modalities,” Mizrahi told me: “All the things that potentially contribute to the pain have to be addressed,” and that can involve fields far outside dentistry. Even dentists themselves aren’t always equipped with all the information: “We get virtually no bruxism education” in dental school, Spencer, the sleep-apnea researcher from Idaho, said.

    With all these roadblocks, many patients never find out why they’re clenching or grinding, says Alan Glaros, an emeritus professor of dentistry at the University of Missouri at Kansas City, who’s been researching the issue for more than 40 years. That’s partially because it’s a difficult problem to not only treat, but also study. Bruxism’s many causes intersect “a lot of disciplines,” such as dentistry, sleep health, and psychology, which muddies the research process. Each field is studying the behavior, but the results will only ever tell part of the story. “People act as if this is all solved, but it’s not,” Glaros told me.

    So for now, mouth guards, meditation, and Botox are what we have. The treatment, in all likelihood, isn’t going anywhere. “As people get to know others who have responded well, I predict that we’re going to see an uptick,” Palomo said. Grinders and clenchers will keep chomping on their plastic night guards or forking up thousands of dollars a year for temporary injections, all in a maybe-successful attempt to quell their pain. If only Botox could banish bruxism like it does stubborn wrinkles.

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    Ali Francis

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  • Dentists at Gateway Crossing Hires New Bilingual Dentist

    Dentists at Gateway Crossing Hires New Bilingual Dentist

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    Venezuela native Dr. Maria Summers joins McCordsville, Indiana, dental office

    Press Release
    –

    Aug 17, 2022


    MCCORDSVILLE, Ind., August 17, 2022 (Newswire.com)
    –
    Dr. Matthew Vogt and The Dentists at Gateway Crossing provide exceptional dental care and an extraordinary patient experience. Recently, Dr. Vogt has brought on fellow Indiana University School of Dentistry colleague Dr. Maria Summers as a second dentist at the practice as featured in the Geist Magazine, a Towne Post Network publication.

    “The goal was always to create a place in this community where patients can go for all facets of dental care,” Dr. Vogt says. “It became clear at the end of 2021 that this was no longer a one-dentist job. Dr. Summers and I have known each other since our time in dental school, and having multiple doctors here will be great from a patient care perspective.” 

    Dr. Vogt is passionate about dental implant surgery and full-mouth smile reconstruction, while Dr. Summers focuses on restorative treatment and root canal therapy. Both doctors continue to concentrate on general family dentistry and cosmetic dentistry as well.

    Dr. Summers also brings an additional service to the table. She was born in Venezuela and is fluent in Spanish. The practice is located near Lawrence, where the Hispanic population is a large part of the community. 

    “Spanish is my first language,” Dr. Summers says. “I think this appeals to Spanish-speaking patients because it’s more comfortable and easier to understand what is going on in your language of origin. It helps to build trust.”

    Dr. Summers aims to educate patients on their dental health as well. By combining forces with Dr. Vogt, they provide a complete patient care experience in one place. Both participate in continuing education and utilize the latest technology to stay on top of cutting-edge procedures.

    Dr. Vogt believes he has found the perfect addition to the practice with Dr. Summers joining the team. 

    “Our team couldn’t be more excited,” he says. “Comprehensive, full-mouth care has become a big part of our practice, but we’re still just as focused on general dentistry and the things that have brought us so many wonderful patients over the past four years. Collaborating with Dr. Summers will benefit our patients immensely and allow us to continue to provide the level of service we believe in.”

    The Dentists at Gateway Crossing is located at 6621 W. Broadway STE 600 in McCordsville, Indiana. For more information, visit their website, visit their listing on TownePost.com local directory, or give them a call at 317-643-9434. For press inquiries, contact Tom Britt at the Towne Post Network (317) 810-0011.

    Source: Towne Post Network, Inc.

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