2015, and What the New Year Means for Dentistry

A look ahead at the most important issues facing the profession

Dental predictions for 2015

Predictions for the field of dentistry in 2015 include adapting to changing health care reforms and ensuring quality, affordable dental coverage for seniors. (Photo: Bigstock)

It’s time to look ahead in 2015 and see what issues are going to be the most important for dental professionals across the U.S. This year, two big issues should be on the radar of everyone in the field: changes due to the Affordable Care Act and aging baby boomers impacting the system as a whole.

Enter Bill Chase, vice president of marketing for :DentalPlans. The company is known for keeping up with the latest trends in dentistry, and with that, Chase has some interesting predictions for 2015.

For one, he says that the current changes in health care just aren’t enough.

“The Affordable Care Act does little to solve the dental crisis in America, especially for adults,” Chase said in an interview with DentistryIQ. “As baby boomers lose their employer-sponsored dental insurance and realize that Medicare doesn’t provide much in the way of dental coverage, there will be an increasing demand to address this issue.”

The hardest part may be trying to find the right balance between making dental coverage affordable without hurting the field altogether.

“As a nation, we need to sort out ways to provide affordable, quality dental care to everyone while still enabling oral health-care professionals to run profitable businesses. If we can’t do that, we’ll start seeing a big spike in dental tourism, and sadly we’ll also see many people sickened and worse for lack of access to affordable dental care.”

Another issue facing dentistry this year is the oral health of the aging baby boomer population. Chase mentions that about one in four Americans over the age of 65 has lost all of their natural teeth due to a lack of affordable coverage. In order to change these drastic figures, dental health needs to be at the forefront of the national health care conversation.

“Affordable preventive care would go a long way toward keeping seniors’ mouths healthy and smiling. We need to stop treating dental care as a luxury option and bring it into the mainstream health care system where it belongs.”

For more of Bill Chase’s 2015 dental predictions, click here: What Will 2015 Bring for Dental Professionals and Patients?


Since 1981, Havel’s has offered premium quality surgical scalpel blades, miniature blades and sutures to dentists, oral surgeons, periodontists, endodontists and other leading medical professionals. To see Havel’s selection of surgical scalpel blades and sutures, please click here: Havel’s Surgical Scalpel Blades, Miniature Blades and Sutures.


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Essentials of Peripheral Nerve Blocks

Advanced technology has made placing blocks safer, quicker and more efficient

Regional anesthesia nerve blocks work well with ultrasound guidance

Advances in ultrasound technology has allowed regional anesthesia techniques like peripheral nerve blocks to become more prominent for surgical pain control. (Photo: Bigstock)

Over the years, advances in ultrasound technology has allowed regional anesthesia to become a viable alternative for pain control and pain management. Procedures like peripheral nerve blocks are now a common option for many practitioners due to the effectiveness of ultrasound guidance. The switch to ultrasound-guided regional anesthesia techniques has transformed the field, giving new light to possibilities that were once thought out of reach.

Today, a well-trained anesthesiologist can use ultrasound to place peripheral nerve blocks with the kind of care and efficiency that couldn’t be achieved a decade ago. Ultrasound gives doctors a more complete visualization when placing blocks, giving practitioners the chance to see the needle as it moves along its path. It also lets them see different internal structures along the way, and avoid any further damage in the process. In the end, all of this leads to more successful blocks and better patient outcomes.

Ultrasound guidance is a breakthrough for regional anesthesia. In order to get the most out of ultrasound guidance, here are a few essentials you’ll need:

  1. Training – advanced training is crucial for any anesthesia providers new to ultrasound guidance. Ultrasound regional courses are available throughout the country, and most are often reasonably priced and not too long. The benefits certainly outweigh any extra time it may take for a course or two.
  2. A designated room – ultrasound-guided regional anesthesia is best performed in a designated area with easy access to all the necessary tools and supplies needed for the procedure. Things like adequate lighting and ample work space help make peripheral nerve block procedures even safer than they already are.
  3. Ultrasound machine – of course, what good is ultrasound guidance without the proper machine? A good ultrasound machine is key, and can run anywhere from $5,000 to $100,000. Depending on your preference, many new machines are easily portable and offer high quality images. The more bells and whistles you want, the higher the price may be. In the end, there are many factors to consider before purchasing the right ultrasound machine, and it’s always better to do research to find the perfect machine for your blocks.
  4. Needles – like a good ultrasound machine, placing a peripheral nerve block is impossible without the right nerve block needle. Today, there are a variety of needles to choose from, based on length, gauge, echogenicity, bevel and insulation qualities. With ultrasound, echogenicity is an important factor to consider, and most new needles tend to focus on their ability to enhance visualization under ultrasound.

To learn more about the essentials for peripheral nerve blocks, click here: Basics of Blocks.


Since 1981, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.


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The Economic Advantages of Regional Anesthesia

Peripheral nerve blocks, continuous local anesthetic infusions save time and money

Regional anesthesia is more effective for post-op pain management

Regional anesthesia techniques are being used more for post-op pain management due to the benefits they can provide to both patients and surgical facilities. (Photo: Outpatientsurgery.net)

For most modern-day anesthesia providers, the biggest reason to use regional anesthesia is because of the vast improvements the techniques can bring to a patient’s post-op experience. Improved patient outcomes can result in major efficiency gains, which means saving time and money for the patient and the facility. Overall, it’s a win-win for everyone.

Regional anesthesia’s post-op analgesic effects are known to dramatically lower pain scores in patients, which then leads to a decline in the use of opioids. Opioid use for post-op pain can increase the risk of grogginess, nausea, vomiting and delirium in patients, some of which are the main causes for prolonged stays in a hospital or surgical facility. More time means higher costs for both patients and insurers. By decreasing the need for opioids and using regional anesthesia, patients recover quicker and are discharged much sooner.

“For an outpatient facility, any technique that avoids the use of opioids is advantageous,” said Mark E. Hudson, MD, MBA, associate professor of anesthesia at the University of Pittsburgh School of Medicine.

“Under regional, within minutes after surgery they’re having 7-Up and crackers,” added David Rosen, MD, president of Midwest Anesthesia Partners of Naperville, Illinois. “In 20 to 25 minutes they’re dressed. In 30 minutes, they’re in a wheelchair, heading for the car.”

Fast-track to success

It’s no secret that fast-tracking surgical recovery times can be financially rewarding, as long as the techniques are seen as beneficial to a particular patient. Since regional anesthesia has already proven to be just as effective, if not more, for post-op pain management, it’s no wonder facilities are beginning to see the benefits these techniques can provide for them as well.

Although there isn’t a big difference between the cost of drugs used for general anesthesia and the ones used in regional anesthesia, others resources still play a pivotal role in the discussion.

“Anything that reduces the time the patient spends in the facility is going to save the facility dollars,” said Dr. Hudson.

“When people are out in under an hour, as opposed to 2-plus hours, you’re saving a lot of money on your personal costs,” added Dr. Rosen.

For more information on the economic advantages of regional anesthesia, including what you’ll need in order to take full advantage of these techniques, click here: Regional Anesthesia’s Economic Advantages.


For over 30 years, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.

 

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Money, It’s a Gas: The High Cost of Being a Veterinarian

Rising student loan debt could be plaguing the profession

Veterinarian student loan debt is at an all-time high

Many young veterinarian school graduates are facing an increasing amount of student loan debt.

This year, nearly 4,000 college students completed their veterinary education and started their journey into the profession, which is up from 2,500 in 2010. While this is certainly good news for the veterinary field, a panel at the most recent American Veterinary Medical Association (AVMA) annual convention titled “Veterinary Oversupply: Issues and Ethics” looked at a number of harsh realities facing the profession, namely, the high cost of student loan debt.

Veterinary students emerging from college can expect upwards of around $150,000 in debt, while only earning a median income of roughly $65,000 in their first year of work. This puts their debt-to-income ratio at 2.4, and when compared to other professions like physicians (1), dentists (1.7) and attorneys (1.7), the problem looks a little clearer, and a lot scarier.

This trend is nothing new. In fact, the last 15 years have shown a disproportionate increase in veterinary student loan compared to an increase in salary. Many veterinary school graduates think pursuing an internship and/or residency program will help in the long run, with the hope of better pay to compensate for the amount of debt accumulated over the years. However, data suggests accumulating interest over a period of time with minimal income doesn’t necessarily help, financially speaking.

So what’s needed to solve the problem? There are a lot of theories, which range from freezing tuition rates to reducing the time it takes to receive a veterinary degree. Above all else, educating the next generation of veterinary students about the realities of student loan debt could help from letting the issue go from bad … to much worse.

To read more about this issue, click here: The Rising Cost of Becoming a Veterinarian.


For over 30 years, Havel’s has offered premium quality veterinary sutures, suture needles and surgical scalpel blades for veterinarians, doctors and other leading medical professionals. To see Havel’s selection of sutures, suture needles and surgical scalpel blades, please click here: Havel’s Veterinary Sutures, Suture Needles and Surgical Scalpel Blades.


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Best Hospitals 2014-15: Honor Roll

16 out of 17 top hospitals rely on Havel’s

best-hospitals-in-nation-US-news-and-world-report

U.S. News & World Report released their annual rankings of the nation’s best hospitals.

U.S. News & World Report released their annual power rankings of the nation’s best hospitals. The study covers nearly 5,000 medical centers and spans 16 medical specialties, ranging from cancer to neurology. The hospitals with high scores in at least six specialties received a spot on the Honor Roll, with only 17 hospitals making this year’s top honor. For the first time, Mayo Clinic in Rochester, Minnesota took the No. 1 spot on the Honor Roll, followed by Massachusetts General Hospital and Johns Hopkins Hospital at No. 2 and No. 3.

U.S. News also ranked more than 600 different hospitals by state, region and metro area, for people who are unable to travel great distances for care. The best regional hospitals were evaluated using the same standards as the national rankings. U.S. News also published a ranking of the best children’s hospitals in the country, which was released in June.

Out of the 17 hospitals that made the Honor Roll list, 16 of them use Havel’s medical products. These include some of our most popular products, from the EchoStim, EchoBlock and EchoTuohy line of specialty needles to our stainless steel and carbon steel surgical blades and autopsy blades. Havel’s is proud to be serving some of the nation’s best hospitals and medical centers, and will continue to uphold our standards of quality, functionality and care in each and every one of our products.

To see the full list of hospitals and read more in-depth content on the rankings, click here.


Since 1981, Havel’s has offered premium quality specialty needles and surgical blades to doctors, hospitals, veterinarians and other leading medical professionals. To see Havel’s selection of specialty needles and surgical blades, please click here: Havel’s Specialty Needles and Surgical Blades.

 

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Neck Pain? Try More Than One Option, Together

“Combination therapy” could be the best answer for long-term relief

best treatment for neck pain is combination therapy

The secret to long-term relief for neck pain could be found in “combination therapy,” according to new research from Johns Hopkins University School of Medicine.

A study based on 169 men and women with common neck pain recommends not one but two different forms of treatment used together as the best option for overall relief, according to a group of pain specialists at the Johns Hopkins University School of Medicine.

Researchers found that a combination of spinal steroid injections and conservative treatment with physical therapy and painkillers could provide the best relief for neck pain over a long period of time. Both steroid injections and conservative treatment work equally well as stand-alone treatments in the short run, but for the best long-term results, a combination of injections, physical therapy and painkillers worked surprisingly well together.

It is unknown why the combination therapy performed better over stand-alone options, and additional studies are needed to determine the exact reason for success. One possibility is that the steroid injections and pain drugs leveraged the effects of each other, while another possibility could be that all the components working together actually complemented one another.

To learn more about the new study, click here: Study Finds Best Way to Treat Neck Pain.


Since 1981, Havel’s has offered premium quality procedure needles for anesthesia and pain control for doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.


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Clearer, Brighter: Ultrasound and the CCR Revolution

A change in methodology created the need for an ultrasound-guided needle

By Zach Rogers

Editor, Havel’s Inc.

Part Two: Corners, cubes and the Havel’s advantage

ccr_needlepointingdown-echogenic-needle-tip-ultrasound-guided-needle-injection

Havel’s “4×4 CCR Pattern” provides maximum reflection for echogenic needles under ultrasound.

Earlier, we looked at how ultrasound-guided needle injections are beginning to dominate the field of regional anesthesia. Terms like “echogenicity” and “needle visualization” became important talking points for doctors wanting a better needle. If the biggest problem was visibility, the answer was found in just three simple letters: CCR.

CCR stands for “corner cube reflectors,” and these multi-angled surfaces reflect sound waves back to the transducer, making the needle appear brighter and clearer on screen. These surfaces offer a number of advantages, including improved shaft and needle tip visibility, thus making the needle more echogenic. CCR marks ensure more exact needle placement in ultrasound-guided procedures like peripheral nerve blocks and muscular skeletal injections, and allow you to see the needle and anesthetic in real-time.

In today’s market, CCR-type markings on both the shaft and near the tip of the needle are common, and this placement does help with echogenicity. However, it makes identifying the exact position of the needle tip more difficult, as one might become confused at differentiating between the shaft and the tip. Ultimately, this defeats the purpose of using an echogenic needle, and it’s why Havel’s has developed special echogenic needles that eliminate the confusion.

At Havel’s, we’ve created what’s called our “4×4 CCR Pattern,” which helps pinpoint the exact location of the needle tip once inside the body. Our echogenic needles have four rows of four multi-angled indentations at the distal end of the needle, which circle around the entire cannula, making the tip appear brighter and in full-view. A total of 16 corner cube reflectors are placed within the first 5.5mm of the needle, allowing you to focus on the tip without any other distractions.

EchoStim-needle-image-ultrasound-ccr

Benefits of ultrasound guidance include better accuracy, faster needle placement and real-time monitoring of anesthesia flow.

Other competitors have reflectors as far up as 20mm of the cannula, which drives up cost and could potentially lead to a false assumption of the needle tip’s actual location. An abundance of reflectors could also blur the target area and create a cloud around the needle. In the end, you shouldn’t pay more for what you don’t need, and with our line of echogenic needles, you get exactly what you need at an affordable price.

Havel’s 4×4 CCR Pattern is available on some of our most popular insulated and non-insulated needles, including the EchoStim, EchoBlock and EchoBlock MSK. Advantages to our 4×4 pattern include better accuracy, faster needle placement, increased success rates and reduced needle sticks and breaks. The 4×4 CCR Pattern also lessens the need for needle rotation because the CCR marks appear around the entire tip. Our echogenic needles allow you to see the needle, confirm the trajectory, locate the tip and watch the anesthetic encircle the target area. At Havel’s, our focus is on the tip, and yours should be too.


For over 30 years, Havel’s has offered premium quality ultrasound needles and procedure needles for anesthesia, pain control, radiology and biopsy, as well as sutures and surgical scalpel blades for doctors, hospitals, dentists, dermatologists, veterinarians and other leading medical professionals. To see Havel’s selection of procedure needles, sutures and surgical scalpel blades, please click here: Havel’s Ultrasound Needles, Sutures and Surgical Scalpel Blades.

 

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Clearer, Brighter: Ultrasound and the CCR Revolution

A change in methodology created the need for an ultrasound-guided needle

By Zach Rogers

Editor, Havel’s Inc.

Part One: The early days of ultrasound in anesthesia

ultrasound_machine_2

Ultrasound has dramatically improved over the years, becoming more portable, more affordable and better able to provide a quality image on screen.

In recent years, there has been a shift towards using ultrasound guidance in a number of different regional anesthesia procedures. Most notably, ultrasound has emerged as a leading force in needle-injection procedures like peripheral nerve blocks and muscular skeletal injections, and because of this there is a large industry demand for better needles that perform well under ultrasound. The market for this demand has exploded in the last five years, and it’s still on the rise today. This new wave in ultrasound technology offers better image quality, better portability and more affordable pricing. Because of this, ultrasound guidance is becoming the standard of care for most regional anesthesia procedures.

The emergence of ultrasound-guided needle injections is due mostly to the significant benefits it provides. Doctors are now better able to position the needle where it’s needed, while at the same time monitor the distribution of the anesthetic in real-time. It also allows doctors to observe the needle’s trajectory as it’s inserted into the body, which makes avoiding internal structures easier than before. Adjustments can be made on the spot, and overall success rates are dramatically increased.

Of course, with new methods comes new tools for those methods, and anesthesia is no different. Since ultrasound guidance is becoming such a dominant practice for needle injections, it would be helpful if the needles could be seen clearly under ultrasound. Conventional needles are difficult to distinguish, and it became obvious that in order to make ultrasound guidance easier for doctors new to the technique, the needles themselves needed to be echogenic.

Echogenicity is the ability to bounce or reflect ultrasound waves back in order to see something clearly on the screen. When ultrasound began making its way into needle injections, the development of echogenic needles came into play. Visualization of the needle is the most important factor in developing better echogenic needle technology, and it can be challenging, especially at steep angles. As echogenic needles became more advanced, improvements were made that allowed doctors to see their needles more vividly than ever before.


Read part two of “Ultrasound and the CCR Revolution” on Friday!


Since 1981, Havel’s has offered premium quality ultrasound needles and procedures needles for anesthesia, pain control, radiology and biopsy, as well as sutures and surgical scalpel blades for doctors, hospitals, dentists, dermatologists, veterinarians and other leading medical professionals. To see Havel’s selection of procedure needles, sutures and surgical scalpel blades, please click here: Havel’s Ultrasound Needles, Sutures and Surgical Scalpel Blades.

 

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Regional Anesthesia Risks: Going From Lower to Lowest

More steps can be taken to decrease risk even more

Neurologic injury from regional anesthesia is very low

The risk of neurologic injury from regional anesthesia techniques is already low, but some feel it could be even lower. (Photo: Bigstock)

Can the risk of neurologic injury due to regional anesthesia go from very low to extremely low? That was the question on the minds of many anesthesiologists at this year’s International Symposium of Ultrasound for Regional Anesthesia, Pain Medicine and Perioperative Applications in Toronto, Canada.

Already, the risk of neurologic injury is low, but some say there are even more steps anesthesiologists can take to reduce the risk even lower.

“What we do is very safe, but this allows us to spend a lot of time talking about the optimal way to make things even safer,” said Kyle Kirkham, MD, FRCPC, staff anesthesiologist at Toronto Western Hospital, University Health Network and assistant professor to the Department of Anesthesia at the University of Toronto, Ontario, Canada. “Can we step back and find an approach that doesn’t require the needle to be in contact with the nerve at all?”

Ongoing research

Research based on the topic of increasing proximity to the nerve without causing injury has been done in the past, but now experts are calling on more alternative approaches to be looked at, such as maintaining a distance from the nerve while still delivering a sufficient diffusion of anesthetic.

Studies concerning current flow and twitch have shed some light on avoiding nerve damage, but nothing concrete has been set forth yet.

“We have discovered that a lot of studies have shown you can be touching the nerve and have high current and not get a twitch,” said Paul McHardy, MD, FRCPC, an anesthesiologist at Sunnybrook Health Sciences Centre in Toronto. “At the same time, you can be outside the nerve, have low current and have a twitch. The architectural structure of the nerves behaves differently in terms of risk.”

Using pressure as a measurement was thought to be a reliable way to minimize the risk of neurologic injury. However, one animal study showed that high injection pressures may suggest intraneural needle placement and result in persistent neurologic deficits, which led the authors to recommend against excessive injection pressure.

One anesthesiologist, Xavier Sala-Blanch, MD, director of the Orthopedic Anesthesia Section at the University of Barcelona, Spain, looked at retrospective research which determined ultrasound guidance can decrease the risk for local anesthetic systemic toxicity after a peripheral nerve blockade.

“It is important that we try to reduce the percentage of injury,” said Dr. Sala-Blanch. “Ultrasound helps us to do this.”

To read more on the topic of reducing the risks of regional anesthesia techniques, click here: Techniques Can Push Regional Anesthesia Risks Still Lower.


For more than 30 years, Havel’s has offered premium quality anesthesia needles and ultrasound needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia Needles and Pain Control Needles.

 

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Radiology and Your Hospital: Rethink and Regroup

Ohio hospital strikes innovative new partnership with outside imaging practice

radiology MRI scan

Aultman Hospital in Canton, Ohio has formed a unique partnership with Radiology Associates of Canton with a focus on both patient and physician satisfaction. (Photo: Bigstock)

Patient care and satisfaction is a top priority for many hospitals and healthcare networks across the country, and many facilities are trying new approaches to keep their patients, and physicians, happy.

Aultman Hospital in Canton, Ohio is doing just that. Three years ago the nonprofit hospital faced challenges typical to anyone working in modern-day healthcare — financial pressure, increased competition — and when it came time to renew the contract the hospital had with an outside radiology practice, Aultman’s CEO Christopher Remark decided it was time for a new approach.

For years, the relationship between Aultman Hospital and Radiology Associates of Canton was all too common. Separated, uncommunicative and lacking in transparency, the time for change was obvious. The two parties worked together to develop a shared vision with the best interests of the hospital and practice in mind.

“When you summed it all up, it didn’t look really good, from our standpoint, from an imaging standpoint,” said Remark. “We really felt that we had an opportunity to do something different because it was right in the heat of [health care reform].”

A new focus

The end result was a shift in focus for Aultman and Radiology Associates, set around incentives tied to quality, patient satisfaction and most importantly, efficiency. Volume and money took a backseat, and the new goals included growing their outpatient market share, instituting patient-centered imaging services and preparing for new payment models for patients.

The first year of the new agreement was 2013, and it was a major success. One of the biggest successes was dropping the turnaround rate for an MRI brain observation report from 24 hours to two. Employee and physician satisfaction is up for both, which then leads to stronger patient care and better outcomes for all.

“This is the beauty of co-management because we were talking strategically, and as a hospital we were behind in these areas,” said Remark. “It was neat to forge a relationship between the cardiologists and radiologists to really make this happen.”

“This would not have happened without a visionary CEO of the hospital like Remark,” said Syed Furqan Zaidi, M.D. and CEO of Radiology Associates of Canton.

For more information on the new partnership, click here: The Radiologist’s Role in Shaking Up Your Hospital.


Since 1981, Havel’s has offered premium quality radiology needles and biopsy needles for radiologists, doctors, hospitals and other leading medical professionals. To see Havel’s selection of radiology and biopsy needles, please click here: Havel’s Radiology and Biopsy Needles.

 

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