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1 Dental Notices No. Toothpaste Correct cleaning and protection Conflict resolution for the female team IZZ press forum celebrates anniversary DP AG Postvertriebsstück tü Fee paid 7443 Issue 22/2014 Deutscher Ärzte-Verlag GmbH Postfach Cologne

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3 3 Editorial Strengthening the living environment of the citizens This is what the new Prevention Act should be about, as the draft now shows. The extent to which justified demands by the dental profession for better care for children under to three years old can be taken up there remains to be seen. Photo: designaart - Dear Sir or Madam, What politics has long been announced is now entering a new round: Health Minister Herrmann Gröhe has presented the draft for a new prevention law. Health promotion and prevention are to be strengthened in the living environment of the citizens in particular. The services of the health insurance companies for the early detection of diseases are to be further developed and the interaction between company health promotion and occupational safety improved. At the German Dental Conference in Frankfurt, which has not yet been completed while this zm edition is going to print, the minister praised the dentists for the fact that the profession has positioned itself in an exemplary manner and achieved many successes in matters of dental and oral health. The paradigm shift towards more prevention has been largely supported by the dentists. In prevention policy, great emphasis is placed on experience in the dental field. The dentists have managed to change behavior in this country. This is good news for the profession. It now remains to be seen how the further legislative process will develop. From the point of view of the profession, there are still important open fields of action in prevention work, for example in the care and care of small children between the ages of zero and three years. The profession had already drawn the politicians' attention to this several times. When it comes to dental prevention, toothpaste is of course indispensable. Brushing your teeth with toothpaste is the best way to prevent tooth decay, care for your gums and maintain oral hygiene in general. The cover story in this issue brings an update on this topic. It explains how toothpaste works, describes the ingredients and explains in detail how to properly brush exposed tooth necks. And if you have always wanted to know how the strips get into the toothpaste, you will find what you are looking for here. Good caries prophylaxis can only be achieved with the help of fluorides. According to information from experts, there is excellent evidence that brushing teeth with toothpaste containing fluoride is effective as a prophylactic against caries. And all statements on the toxicity of fluoride in dental care products make it clear that the fluoride concentrations used are so low that they do not pose any health risk. Change of scene: Communication is a topic that is indispensable in the daily practice of the dentist, be it in dealing with patients, in collegial interaction and of course also in the team. If there are conflicts, suitable strategies for de-escalation are called for. How do women behave in disputes? The article in the booklet about solution strategies for interfeminine conflicts offers useful and informative information for emergencies. Sincerely, Gabriele Prchala Deputy Editor-in-Chief at 104, No. 22 A,, (2629)

4 Photo: CC 22 Most of the winding towers in the Ruhr area have long been idle. In return, the health industry in the West is moving more and more. 34 The selection of toothpastes on the market is growing every day. The cover story sums up what really matters. Photo: F1online / Cover photo: F1online OPINION Editorial 3 Leading article 6 Readers' forum 8 Guest comment 18 COVER STORY Toothpaste Correctly cleaning and protecting 34 POLITICS Health promotion in focus 20 Health industry in the Ruhr area A giant awakens 22 IZZ press forum 2014 Take a close look 28 zm Visit us at Internet at Sächsischer Zahnärztetag Chemnitz. Children. Caries. 30 Bavarian Dental Conference The profession has turned inside out 32 cm 104, No. 22 A,, (2630)

5 5 Photo: K.-L. Ackermann Photo: psdesign 1 - Photo: AlexOakenmann - Clinically proven: Electric tooth search for warning signs: Rare brushes with small, round brush heads remove plaque better than manual toothbrushes. Neurological diseases such as spinocerebellar ataxias are often diagnosed too late. Looking for a new colleague? Ten tips to make it work. DENTAL MEDICINE Biofilm management through oral care Opportunities through oral hygiene 42 The special trauma case Avulsion with lip perforation 48 MEDICINE In the focus of the Neurowoche Rare Neurological Diseases 52 SOCIETY 25 years of KpZ patient education is an iron goal 72 Dortmunder Zahnärzte e.v. Gold for children 74 Dentists without borders in Namibia Show your teeth 76 PRACTICE Security for the end of your life So that your dreams don't burst 78 Investments The multiplication table for shares 80 Interfeminine conflicts in everyday practice Solution strategies for the team 84 Staff How to find the right colleague 88 Data protection in the dental practice Treatment in the nursing home 90 MARKT Company portrait: SHOFU The spirit of research from the Far East 98 News 100 RUBRIKEN News on 10 News 12, 127 Appointments 56 Reviews 92 Personal 97 Imprint 126 Last but not least, 130 cm 104, No. 22 A,, (2631)

6 6 Leading article Time for an update Dear colleagues, so completely internalized, but the wishes for more family also have positive effects while this zm edition is going to print, the German Dentists' Day in Frankfurt is the annual major event of professional politics and science, to the whole of society. It is up to us professional representatives to motivate young dentists to become freelancers and not yet offer them attractive opportunities. For the possibilities for the way Federal Dental Association hand in hand with politics in the establishment of the practice stands with the political go, which could show in Germany. Debates there above all so well-established structures Just this freelance work is a topic in focus: the freelance work will soon be seen from another side in the self-image of history. under pressure, namely chamber work in the course of a changing society. The regional chambers, together with the German Dental Association, are responsible for ensuring that their main task, namely guaranteeing the high quality of dental care in Germany, is implemented and expanded. Social trends present the profession with new challenges. We as chambers of Europe under the heading of deregulation. In other EU Member States, the freelance category is often unknown and the liberal professions are seen as normal entrepreneurs. As part of the so-called transparency initiative, the rules of access to and exercise of the profession of all regulated professions are now being reviewed; the EU wants to generate more economic growth in these developments on the common internal market. take, rethink our role and position ourselves for the future. First of all, today's young generation strives for a better work-life balance. Work-life balance also takes precedence over the dentists. That is why the chambers there are also criticized, the development does not stop at the chambering of the liberal professions. If we do not take action early on and go hand in hand with politics, the tried and tested in Germany could not stop. Many representatives of the professional structures of the freelance soon have this fact while not yet to be history. We call on politicians, Photo: BZÄK-Pietschmann, to work for a European charter for the liberal professions to ensure professionalism, public service obligations, self-administration and personal responsibility in the dental profession. Our chamber system has proven itself as an exemplary model of a liberal and at the same time serving state organization. It brings the interests of the profession in line with those of society through its statutory public service obligation. The central task of the chambers is quality assurance: they must effectively and efficiently ensure quality in professional practice as well as in further and advanced training, as is also laid down in the laws of the medical professions of the federal states. It is precisely here that the chambers must be pioneers in that they use every opportunity to organize the latest knowledge for their members to be imparted independently of economic interests. Given the changing structures within the dental profession, we chambers must ensure a common set of values. This should be the basis for both professional cohesion and a high quality level of professional practice. For this it is necessary to actively shape the self-image of the profession and to convey a uniform professional understanding. It is important not only to make legitimate demands on politicians, but also to support them with professional expertise. If we want to maintain the attractiveness of freelance work, we have to enter into an active social dialogue. To do this, it is necessary to advance the modernization of our self-image before encrusted structures from inside and outside are called into question. Sincerely, Dr. Peter Engel President of the German Dental Association zm 104, No. 22 A,, (2632)

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8 8 Readers' forum Return to the front door To the cover story Problem antibiotics Ineffective wonder weapons, zm 16/2014, p. 32ff. this preparation has a poor tolerance spectrum as well as a bad resistance spectrum (in our practice up to 50 percent), it is misleading by colleagues with every swelling or pain in the area. 2014, p. 40ff. With the title curious, he is actually DG-PARO specialist for periodontology or Dr. Walter M. Eggerath? If you read the zm article carefully, you will notice that the dental treatment, the alcohol test to the article I would like to be prescribed as of the mouth. So I was very interested in going ahead, from a dentist and veterinarian a few please in the future no pictures the designated post jelly disinfectant mouthwash, make comments. Unbearably from dire conditions. In doing so, I noticed a local anesthetic, the preps we have in Germany in the animal fattening, but must that the title wrong and ration of maxillary molars land a relatively big problem sweeping on your own doorstep. therefore is completely misleading. and premolars for partial crowns There is also a lot to do with hygiene in dental medi- The question of the extent to which the irrigation and ceramic inlays, the touchyzin with regard to alcohol-containing tooth stumps have a lot to do with hygiene. 0.2 percent chlorhexidine 70 percent alcohol solution, Thomas Meyer, dentist for oral surgery and veterinarian digluconate solution and touching freshly prepared tooth stumps with 70 percent impression and temporary restoration of the prepared teeth. In what form chewing gum bubbles according to alcohol one carried out almost nine hours later was a periodontal treatment / a periodontal treatment. Cover: DART To the article Stigmatization in (dental) medicine, zm 17/2014, p. 56ff. Being able to influence breath and blood alcohol tests is of course interesting for all colleagues. The result of the dem zmung made? The subgingival preparation of a tooth, if it took place here at all, would not be more likely to cause the periodontal malignancy than the treatment pathogens, which is the cause of the development of resistance. It helps every doctor as the subject of expert reports. Already doesn’t justify mutually stigmatizing each other, namely that the blood alcohol - the antimicrobial mouthwash - to blame for it. Big on his concern: the mirror through the term Paro-Be in the dentistry. Both in the article and migrants. treatment used act? Sure, somehow at serious congresses difficulties and misalcoholic solutions also benefit the periodontium, the cause of the problem was almost completely and there are nine hours unaffected by it. But in what has been described, the veterinary medicine is constantly being given over and over again, just being stigmatized is also helpful. For context, it is more likely to be written, whereby a tion is always something very violent. expressly not in the foreground of the authors. Here went tons of antibiotics used thanks for the things mentioned. it is more likely to be used for a germ. On the other hand, that is a word in blatant excess. However, it is not only the reduction in the oral cavity before consumption in human medicine that is great! Mr Groß would like the case described, but also a tooth preparation, which is named in prescriptions, simply, it seems to me, the title of the article curious: Aerosol creates. whereby the ton consumption here is based on a certain migrant problem blood alcohol level. The title is wrong and therefore at least as high must pay homage to the Paro treatment. What should be misunderstood. It's like in veterinary medicine. Incidentally, transcultural competence. Paro treatment mean? This post is not about one said, veterinary medicine also consists of Heijaja. How about it instead? The term is not used in the text Paro treatment. not just from animal fattening. All medical schools should look for solutions as quickly as possible and not get involved in trench warfare. with demanding the migrants' obligation to deliver, namely language, language, language, i.e. German in Germany? I consider THAT to be explained in more detail. Paro is mostly used as an abbreviation for the word periodontology or the word part periodontal. The co-authorship of Spe- Univ.-Prof. Dr. Peter Eickholz Polyclinic for Periodontology Center for Dentistry, Oral and Maxillofacial Medicine (Carolinum) Frankfurt / M. How slowly is science advancing in the sense of avoiding periodontics specialists, Dr. knowledge, for example misunderstandings. Jobst Walter Eggerath, who sets the standard in dentistry, shows very well the prescription practice of clindamycin. Although it is common knowledge that R. Nicolaisen dentist Nikolaistr Flensburg suggests that periodontal treatment is meant here. But who is actually co-author here? Dr. Jobst Werner Eggerath, the zm-Redaktion is free to accept letters to the editor and reserves the right to make meaningful cuts. zm 104, No. 22 A,, (2634)

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10 10 online new news There are even more exciting topics online. Eight months after a robbery, a 40-year-old suffered from a painful jaw clamp. The shadowing in the orthopantomogram, which required clarification, provided the central indicator for the search for the cause. Alarming self-assessment A pioneer of surgery The health insurance company dedicated to Stefan Böhm explains why Until 25 years ago there was in. This shows in a unification of Bavaria (KZVB) he has some of the results alar-Hilden does not have a central exhibition now many new over 60-year-old contract mates. Place where the works of the exhibits, including dentists, asked how they founded the scientific medical instruments and the future of dental surgery. niche supply in the free zm code: shows was. Then it became zm-code: state see. Vice-boss Dr Wilhelm Fabry a museum Extraordinary jaw clamp zm-code: Photo: Schnabel et al. To learn dentistry with a card game How does the crown escape in the fourth quadrant work? Which tooth shape is characteristic of the 45? One thing is clear: dentistry students have to grind a lot. It works in a playful way with the card game Der Biss and the associated app. zm-code: MORE ON ZM-ONLINE Explanations zm-codes Here you will find the direct links to the articles described on zm-online.To do this, simply scan the QR code with a smartphone or tablet app or enter the numeric code in the search mask at the top right of the website. zm 104, No. 22 A,, (2636)

11 Practice for the homeless before the end of Dr. Christian Bolstorff, former president of the Berlin Dental Association, explains in an interview why he considers helping the poorest of the poor as social: The district government wants to understand the subsidies for them. zm-code co-founded by him: homeless practice delete signposts in the direction of the university children from families without made it. On her way to an academic background, she's less likely to take up a degree. The two dental compass support program for study medicine students Felix Herbertz and Denys Kucher hasm-code: glides. Nonetheless, she went to the university nun and dentist Sister Fabian from Kenya was followed by Dentists for Africa. In an interview in Berlin she reported two very different vocations: She is a nun in the care of the dental order of the Little Sisters of St. in Francis and at the same time a dentist. The course enables zm-code: Kenya. open her a scholarship of the TOP IMPLANT OFFER 11% DISCOUNT * Special ON THE DENTAL SERVICES OF THE IMPLANT SUPRA-CONSTRUCTION GET TO KNOW-HOW OFFER FOR NEW CUSTOMERS 22% DISCOUNT ** ON THE SERVICES OF THE 1ST WORK FOR DENTAL REPLACEMENT -wide, four million people each year develop nosocomial infections and die. Copper door handles make a contribution to practice hygiene, because pathogenic germs are eliminated. Clinics are now relying on this structural measure of hygiene management. zm-code: * The offer is valid for orders from to The discount for implant superstructures relates to the dental services provided by dentaltrade (price list 04/2014). The discount campaign cannot be combined with other offer prices and is aimed at all dentists established in Germany. The order date of the practice applies. Changes and errors excepted. ** The offer is valid for the first work and is valid from to. It refers to the dental services of dentures as a whole (price list 04/2014). The discount campaign cannot be combined with other offer prices from dentaltrade and is aimed at all dentists established in Germany who are using the dental technology services of dentaltrade for the first time with the offer. The order date of the practice applies. Changes and errors excepted. [HIGH QUALITY GEAR SET AT CHEAP PRICES] FREECALL: (0800) 247zm, /// Nr A,, (2637)

12 12 News Saarland apprenticeship contracts at the top When it comes to the number of newly concluded apprenticeship contracts for dental assistants (ZFA), the dental practices in Saarland occupy a top position nationwide. While the number of apprenticeships across Germany is falling by 2.9 percent, the dental practices in the small federal state, with 147 new contracts, have the highest rate of increase of 18.6 percent. At the same time, this represents a record number compared to the past ten years, in which the number of training positions fluctuated between 108 and 124, reports the Saarland Dental Association. According to current data from the Chamber, 233 of 462 dental practices are being trained. This corresponds to a rate of 50.4 percent with an average of 1.4 head physicians turnover in the head Photo: contrastwerkstatt - trainees per training practice. For comparison: in industry and craft, a maximum of one third of the companies achieved this quota. We are leading this success, reports the Chamber Chairman of the Medical Council Dr. Hans Joachim Lellig, on our increased advertising measures at training fairs, our participation in the training project now and, last but not least, on our entry into the collective bargaining association with the Federal Association of Medical Specialists. Throughout Germany, a total of training contracts were concluded up to September 30th this year. In addition to the Saarland, significant gains were also recorded in Hamburg, Baden-Württemberg, Brandenburg, Rhineland-Palatinate, Thuringia and Schleswig-Holstein. In contrast, losses can be seen in Bavaria, Saxony, Berlin, Lower Saxony and North Rhine-Westphalia. The values ​​remained stable in Hesse, Saxony-Anhalt, Mecklenburg-Western Pomerania and Bremen. nh / pm Health policy Greens criticize Gröhe reform The health minister praises his health insurance financial reform as a relief model for millions of insured persons. The Greens see it differently. You have accused the federal government of offloading cost increases in the health care system on the back of the insured. The additional contribution for statutory health insurance, which will be set by the health insurers from 2015 and borne solely by the insured, is expected to rise in the coming years from an average of 0.9 to more than two percentage points, said the health policy spokeswoman for the Green Party , Maria Klein-Schmeink: With the targeted underfunding of allocations from the health fund and the freezing of the employer's contribution, the federal government is driving a rapidly increasing burden on the contributing insured. The previously fixed special contribution of 0.9 percentage points, which is added to the rate of 14.6 percent, which is borne equally by the insured and the employer, will be converted into a contribution to be determined individually by the health insurers in 2015. Photo: MEV In the first year, according to the prognosis of the Ministry of Health, it corresponds on average to the previous fixed special contribution, but then an increase is expected. Health Minister Hermann Gröhe (CDU) hopes that the GKV financial reform will result in more competition among health insurers in favor of the insured. In the event of an increase, the insured person has the option to switch. According to Klein-Schmeink, the consequence of this is an austerity policy by the health insurers at the expense of the patients. Only well-funded health insurers will rely on individual special services and bonuses in order to attract high-contribution, young, healthy members and to prevent migration to private health insurance. mg / dpa Leading clinicians have, according to a bed occupancy, the severity of the case, the patients find that analogous to this. only DRG systems are in the management and more care are employee apartments, kindergartens tactical and revenue-relevant for the medical clinic staff in general than the senior physicians. for the hospital staff and the control variables in their heads. Patient present. Assistant and staff hygiene and cleanliness are part of job satisfaction, strategies for on-site physicians are still the focus of all those surveyed, while the senior clinicians focus on further and further development some time for the patient and interest. That should be due to the little consideration. Your clinical facility, they take care of the patient discussion about hospital infections. The study: There were 257 welfare of the employees and additional satisfaction and assistance, infections. Ward physicians for patients, 247 ward physicians, 143 social benefits for the balance sheet, the authors of the study are closer to the patient and the chief physicians, but senior physicians in charge of staff find none or none. That interests the senior gen value on good advice, and consulted senior physicians. sg / pm hardly any attention. medical staff less. Friendliness and assistance to zm 104, No. 22 A,, (2638)

13 Replacement funds Hospital reform is needed The replacement funds have called for a comprehensive reform of the hospital structure. Quality and accessibility should be the focus of future hospital planning. The chairwoman of the Association of Substitute Funds (vdek), Ulrike Elsner, presented a report by the Rhenish-Westphalian Institute for Economic Research (RWI) on hospital planning 2.0 and advocated nationwide uniform quality and accessibility standards. These should be binding for hospital planning and budget negotiations between the health insurances and the clinics in the federal states. Countries, hospitals and health insurers should over, under and European Central Bank apobank passes stress test The Deutsche Apotheker- und Ärztebank (apobank) has the so-called stress test, which was carried out before the European Central Bank (ECB) took over banking supervision with a good result passed. In the so-called baseline scenario of the ECB (expected economic development), apobank achieves a core capital ratio of 17.3 percent. In the adverse scenario (crisis scenario) the rate is 14.7 percent. In both scenarios, apobank clearly exceeds the minimum quotas of 8 and 5.5 percent required by the ECB. The only slight decrease in the amount of 1.8 incorrect supply compared to the market. Hospitals that carry out poor quality or particularly unnecessary operations over the long term should be excluded from the care, demanded Elsner. Boris Augurzky from RWI explained: The problems we have in hospitals today are the result of the country-specific hospital landscape that has evolved over time and its continuation: too many small units, too high a hospital density, too few specializations, too little quality orientation. By the end of the year, a working group from the federal and state governments is to develop key points for reforming the hospital structure. According to a statement from the bank, ck / dpa percentage points in the hard core capital ratio in the adverse scenario prove the economic stability of apobank, which is based on its focused business model and conservative risk policy. We are very happy with the result. It confirms the hard work we have done in recent years to put apobank on a solid foundation, said Herbert Pfennig, spokesman for the Management Board. The stress test shows that we have made apobank crisis-proof. In the ECB's stress test, 25 of the 130 institutions examined in the euro area had failed as of December 31, 2013. mg / pm icron Too much forest to see the individual tree? You're probably not the only one feeling this way. The market for dentures is confusing, there are many providers and offers. That makes it difficult to orientate yourself. It's good that there are trees that stand out from this forest. The icrone is such a light in this jungle. Their stability shines just as brightly as the quality of the material and workmanship. It is perfect for the anterior region and since its market launch in 2011 nothing has changed in the unbeatable all-inclusive price of 99 per unit. This is why you and your patients have two reasons to be happy. So get off the wrong track that quality has to be expensive. We will describe the glowing path to you free of charge at imex-zahn zm 104, No. 22 A,, (2639)

14 14 News Poor hygiene in clinics Debate about pressure to save References to hygiene deficiencies that allegedly never reached the clinic management: In Mannheim, a scandal over dirty surgical instruments throws light on the dark side of the German hospital landscape. The Frankfurt expert for hospital hygiene, Christian Brandt, sees a general problem. On the one hand, everyone in the healthcare system always wants and has to save money, he says. On the other hand, the reprocessing of surgical instruments is becoming more and more complex. In the last 10 or 15 years, the legislature has tightened the screws. Photo: Tobilander - WHO has attracted more sick people worldwide. Sterilization staff should be very well trained and know what to do with the blood-smeared devices. In the Mannheim case, not the entire cleaning staff was adequately trained, as the clinic admitted. Hygiene problems in hospitals are not uncommon, says Niko Stumpfögger, head of operations and industry policy at the Verdi union. However, this usually does not apply to the OP. In the operating theater, people are most likely to check that the cleaning quality is maintained, because it is so particularly important there. The Association of Local Hospitals (IVKK) is also concerned about the increasing economic pressure on clinics. This will tend to lead to fatal wrong decisions, criticizes IVKK boss Bernhard Ziegler. mg / dpa In 2020, for the first time in human history, the number of people over sixty in the world will be greater than that of children under five. The World Health Organization in Geneva refers to this. The proportion of sick and frail old people will also increase worldwide. By 2050, the number of people over 60 will climb from 841 million today to over two billion. The WHO fears that people over the age of 60 will not be healthier than their contemporaries today. The number of demented patients alone will triple by 2050 from 55 today to around 135 million. This means that fundamental reforms of health systems and social assistance systems are necessary, explains John Beard of the WHO Department of Aging and Life Course. While there are already studies on the health of the aging population from countries such as Brazil, China, India and South Korea, such data are still lacking from many regions outside of the industrialized countries. sg / dpa COMMENT Mannheim is everywhere So now Mannheim. You don't need to point your finger specifically at the hospital there: hospitals, with their structural and work-organizational interdependencies, are per se susceptible to, let's say, processes that don't belong there and / or can disrupt the smooth process. Employees have to adhere to numerous regulations that serve patient and employee safety, but they also reduce the complexity of training teeth. Dental students invest significantly more time in their studies than their university colleagues in other subjects, on average they study 9.5 hours more per week. While students in other subjects are busy with an average of 33 hours per week, prospective dentists learn significantly more with 42.5 hours per week. This is the result of the current student survey of the University of Konstanz. According to this, only veterinary medicine students work more. You state 44.6 hours per week as the average weekly working time. Sociology students bring up the rear with 22.6 hours per week. In the student survey since 1982, students at 25 selected universities have been surveyed in writing about their study situation and their orientations, as a rule every three years. Die Studienmacher Photo: WavebreakmediaMicro - increase the workflow. Mannheim is representative of the general situation in the healthcare sector. Because doctors as well as those responsible for clinics are under enormous quality, cost and time pressure across Germany, coupled with meticulous safety requirements. But: Politically, the immense pressure in the kettle is wanted. Clinics and medicine as a whole should address this issue more publicly. Stefan Grande ask specific questions about personal motivation and academic success, as well as about difficulties, the quality of university education and career prospects, always from the perspective of the students. According to the study, the majority of students find it more important to get good final grades than to finish their studies quickly. With regard to their studies, the respondents would especially like a stronger practical relevance. A large majority of the students rate the quality of teaching and the range of courses as positive. nh / pm zm 104, No. 22 A,, (2640)

15 Patient law Second medical opinion often unknown A quarter of Germans do not know that, regardless of the type of illness, they have the right to a free second opinion from another specialist. Among the 18 to 24 year olds the proportion is even 40 percent, while the 50 to 64 year olds, on the other hand, know 96 percent of the right to a second opinion. These are the results of the study on second opinion procedures from the patient's point of view at the Asklepios Kliniken Hamburg and the Institute for Management and Economic Research (IMWF). 15 percent of Germans believe that they have to bear the costs for a second opinion as a patient themselves. Six percent assume that obtaining a second opinion is only free of charge before an upcoming operation. Four percent do not even know that they can request a second opinion themselves. They assume that only their doctor treating them can consult a colleague if necessary. Most of the patients were not actively approached by a treating specialist about the option of a second opinion, either in the practices or in the clinics. There is great interest in a competent second opinion: On average, every second German citizen has already received a second medical opinion on a planned treatment. In 54 percent of the cases, the patients requested this second assessment themselves. In one third the procedure was initiated by attending medical practitioners, in 11 percent by hospital doctors and in 2 percent by health insurance companies. The Asklepios Kliniken Hamburg carried out the study with the IMWF in August 2014. mg / pm Made of fl exible plastic The complete model casting E-Health Government pushes telematics The federal government wants to push ahead with the development of the telematics infrastructure. A ministerial draft for the E-Health Act should be available this year. This was confirmed by Oliver Schenk, Head of the Health Policy Department at the Federal Ministry of Health in Berlin.As the Ärzte-Zeitung reports, the law is intended, among other things, to create the conditions for medication plans and discharge letters to be bindingly applied to the telematics infrastructure. In addition, a directory of interfaces is planned, which in future will ensure that all telemedicine users can communicate with one another and exchange data. We have to ensure interoperability between the more than 200 IT interfaces in the health system, quoted the newspaper Schenk. The Ärzte-Zeitung writes that telemedicine can actually improve the quality and cost-effectiveness of medical care has now been proven by various projects and scientific studies. so called 3-unit bridge VMK Our telescopic work Quality tooth replacement from Protilab 104, No. 22 A,, (2641)

16 16 News Hepatitis C Only comprehensive preventive care helps Photo: Alexander GI - On the occasion of the European conference on hepatitis C in Berlin, it was quickly agreed that many infections and deaths could be avoided with better prevention. Around 300 experts from science, non-governmental organizations as well as institutions and projects dealt with the challenges in the prevention and treatment of hepatitis C in intravenous drug users. The central message of the Berlin Declaration was: Hepatitis C is a major global health problem. It is now time to act, they said, referring to the roughly nine million people with chronic hepatitis C who live alone in European countries. In the opinion of the specialist conference, there are only inadequate or no strategies at all against the viral disease, which can lead to liver cirrhosis and liver cancer. There is a need for action in prevention as well as in early detection and access to treatment for all those affected. In Germany, too, the measures against hepatitis C are by far not sufficient, explained Sylvia Urban from the board of directors of the German AIDS Federation. There are many ways open to us to stop this drastically underestimated epidemic, but politics must prepare the ground. Highly effective measures such as the distribution of syringes in prisons, which would also prevent HIV infections, are politically blocked in the federal states, she says. Prevention is not only a requirement of human dignity, but also much cheaper than the complex and cost-intensive hepatitis C therapies. mg / pm Working Group Roentgen Entire Board of Directors re-elected The working group Roentgen in the DGZMK (ARö) met at the end of September in Münster for their annual meeting and elected the board. The entire line was confirmed in office. Also for the next two years the ARö will be chaired by the 1st chairman Dr. Christian Scheifele, Hamburg, the 2nd chairman Dr. Burkhard Maager, Denzlingen, and the secretary Prof. Stefan Haßfeld, Dortmund. The board of directors was commissioned by the general assembly to advance the development of standardized and legally secure options for the transfer of digital X-ray data that are reliable for diagnosis. Concern has been expressed about the declining importance of X-ray diagnostics in dental education at many German universities. jt / pm Gustatory sweating Botox injections help After operations or injuries to the salivary glands or the neck, the impulses of the nerves used for salivary secretion are sometimes misdirected - they are docked on the sweat glands. The result is so-called gustatory sweating, also called taste sweating. In situations that normally trigger salivation, such as eating, chewing, sucking, or biting, profuse sweating occurs in areas of the face and neck. Dr. Sabrina Köhler and her ENT colleagues at the University of Göttingen report on a patient who, after several operations on the face and neck, suffered from excessive taste sweating and felt extremely impaired in his quality of life. The sweat-covered area extended from the triangle of the neck to the hairy scalp of the man. Treatment required multiple injections of botulinum toxin A (Botox) under general anesthesia. Despite a slight restriction of the facial muscles, the patient is extremely satisfied with the dryness of his face achieved through Botox. sp / thy Source: GMS Curr Posters Otorhinolaryngol Head Neck Surg 2013; 9: Doc34 German Society for KHK Research Cocoa reduces cardiovascular risk Regular consumption of cocoa and the cocoa flavonols it contains has a positive effect on vascular function and reduces it the risk of cardiovascular disease is clear. This is the result of a study by the University Hospital Düsseldorf, which was presented at the congress of the European Society for Cardiology (ESC) in Barcelona. According to study author Dr. Roberto Sansone. A total of 100 people between the ages of 35 and 60 who showed no signs of vascular disease took part in the placebo-controlled study. The participants in the study group consumed a drink containing 450 milligrams of cocoa flavonols twice a day, the control group a flavonol-free drink. The flow-mediated vasodilation, a measurement variable for the vascular function, as well as blood lipid values, blood pressure and pulse wave velocity, an indicator for the elasticity of the arteries, were recorded. After a month, the vascular function of the flavonol users improved, the blood pressure and LDL cholesterol levels decreased and the HDL cholesterol increased. The sum of these effects significantly reduced the cardiovascular risk determined using the Framingham score: the risk of coronary heart disease (CHD) decreased by 32 percent and that of a heart attack by 22 percent. The risk of dying from CHD fell by 34 percent, and the risk of death from cardiovascular disease by as much as 43 percent. sp / pm zm 104, No. 22 A,, (2642)

17 17 Trauma treatment Reimplant as quickly as possible An immediate root canal treatment (WKB) in the event of trauma can help to avoid early and unplanned tooth loss. These new ideas in traumatology presented Prof. Dr. Yango Pohl, Bonn, in his specialist lecture at the Saxon Dental Day in Chemnitz. According to Pohl, the analysis of clinical studies shows that despite delayed treatment in accordance with the guidelines, tooth loss can often be expected just a few weeks after replantation. In contrast, immediate physiological tooth rescue significantly reduces the risk of infection. With the previous therapy method in traumatology, endodontic infections occur in around 40 percent of cases. If the tooth has only been dry for five minutes or less, according to international studies such as those of the International Association of Dental Traumatology (IADT), infections only occur in ten percent of all treatment cases. Reimplanting as quickly as possible is unfortunately not always that easy, Pohl admitted. If it is your own teeth or those of family members, the easiest way to transport a knocked out tooth is in your own saliva. However, since the risk of aspiration should not be underestimated, a larger portion of spit in a shot glass is enough. However, this method should not be used with strangers because of a possible risk of infection. Good alternatives are, due to their sterility, long-life milk or physiological saline solutions. Since many people do not know this, it is necessary to provide more tooth rescue boxes. On his website, Pohl provides information on preventing dental accidents, correct behavior and current treatment options. jt Freecall Did you know that Permadental can usually also deliver larger crown and bridge work on implants in just 9 working days *? Free order service for your implant parts from our competent implant service team contrastwerkstatt - Ruhrstil advertising agency Our team, which is managed by a master dental technician, will be happy to assist you with any questions you may have about our dentures. We carry out minor repairs within 1 to 2 working days after receiving the work Your patients will receive a guarantee pass with every custom-made dental product. This lists all materials with batch numbers for complete documentation.You will receive cost estimates within a few minutes by email or fax * plus the time required for any implant parts orders Permadental. We stand for the future of dentures. zm 104, No. 22 A,, (2643)

18 18 Guest Comment Keystone for Prevention On October 31, the BMG sent the draft of a law to strengthen care in statutory health insurance, in short the GKV-VSG, to the associations entitled to comment. In addition to many other content, some of which are controversial, such as the implementation of the innovation fund by the Federal Joint Committee, 22a, which has been newly added to SGB V, contains regulations that are highly relevant for dentists. Paragraph 22 bears the heading Prevention of dental diseases (individual prophylaxis). In particular, benefits for patients from 6 to 18 years of age are stipulated by law. With the new GKV-VSG, the prophylaxis services are to be extended to those in need of care and people with disabilities, i.e. specifically the assessment of the oral health status, information about the importance of oral hygiene and measures to maintain it, the creation of a plan for individual oral and prosthesis care as well as the removal of hard plaque. Caregivers of the insured person should be involved in the clarification and the preparation of the plan. The Federal Joint Committee is to define the details and the specific scope of services in guidelines. This is another stone, a kind of prevention keystone, to be set in dental care. Immediately after the draft became known, the KZBV chairman, Photo: private Wolfgang Eßer, expressly welcomed this part of the draft, namely the enforceable right of the disabled and those in need of care to dental prophylaxis. But not only he, but also BZÄK President Peter Engel expressed himself publicly and expressed the hope that this 22a will survive the parliamentary procedure unharmed. Maike Visarius, M.A, health policy journalist from L et V Verlag sees light and shadow in the draft law to strengthen medical care. However, the GKV-VSG does not take sufficient account of the expense involved. One should not take these innovations for granted, as one still encounters rather strange attitudes, also in politics, on the necessity of prophylaxis, for example for those in need of care, which are probably not expressed publicly for reasons of political correctness. Obviously, the years of drilling thick boards by the National Association of Statutory Health Insurance Dentists have paid off for the benefit of the affected patients and the dental profession. This 22a is the Photo: adpephoto keystone in the prophylaxis concept, which is round. On the other hand, the new 119c (medical treatment centers), among other things, has led to a certain degree of skepticism among the dental profession. The offers of these centers, especially for the group of people described above, could, according to the explanations of the draft law, also include dental services. Eßer doubts whether this will improve dental care for this group of people and calls for adequate anesthesiological coverage. But also new regulations for MVZ and the new freedom of the health insurances are criticized. Engel opposes legal efforts to substitute (dental) medical services in model projects. The protection of the patient is at risk and quality assurance is being undermined. He also sees a risk to the free choice of doctor, for example, in the regulations on second opinions. But the GKV-VSG is still only a draft and has to go through the parliamentary procedure, and a law has never come out unchanged from the Bundestag. The health policy Berlin, including the dental profession, are facing busy, hectic months, because the BMG has just sent a draft for a prevention law and an e-health law is to be presented before Christmas. The Christmas break has thus been canceled this year. Guest comments are not always what the editors believe. zm 104, No. 22 A,, (2644)