Jack E. Wasserstein, DDS, Inc.

Mini implants used to stabilize a temporary denture

Jack Wasserstein, DDS — Thu, 22 Apr 2010 18:45:43 +0000

In this case, mini dental implants (Dentatus Atlas system) are placed along with the permanent dental implants (Nobelbiocare Tapered Groovy system). The mini dental implants are used for the purpose of stabilizing the temporary denture. By using this technique the temporary denture can be modified by removing the palatal aspect as well as decreasing the denture flanges. This modification of the temporary denture is typically performed by the restoring dentist. Some of these aspects were performed at the time of surgery just to get initial stabilization. Guided implant surgery was also used for the placement of the permanent implants. The following slide carousel demonstrates the procedures performed and will be update as more photos are available.

Gum graft with simultaneous root coverage

Jack Wasserstein, DDS — Sun, 14 Mar 2010 06:58:50 +0000

In this case, we are adding a new method to the standard procedure by advancing the gingival collar coronally to cover the root surface at the same time we are adding the graft to increase the zone of attached gingiva. Note the difference in root coverage before and just one week after the procedure.

Placing the graft directly over the root surfaces at the time of surgery typically doesn’t work, as there is no blood supply to nourish the graft over the root surfaces.

With this technique, the gingival collar that we are advancing maintains its blood supply from the adjacent gingival papillae, and is supported in its new position by the donor tissue.

Gingingival graft with simultaneous root coverage

Jack Wasserstein, DDS — Sat, 13 Mar 2010 21:27:58 +0000

Placing the graft directly over the root surfaces at the time of surgery typically doesn’t work, as there is no blood supply to nourish the graft over the root surfaces.

With this technique, the gingival collar that we are advancing maintains its blood supply from the adjacent gingival papillae, and is supported in its new position by the donor tissue.

The American Academy of Periodontology Issues Statement on Periodontal Treatment During Pregnancy

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

Because of the potential impact that periodontal disease has on the risk of preterm births, the Academy urges women to care for their periodontal health while pregnant. (American Academy of Periodontology press release) CHICAGO–January 30, 2009–Research recently presented at the annual meeting of the Society for Maternal-Fetal Medicine found that routine periodontal treatment in pregnant women did not reduce the risk of preterm deliveries. Some previous studies in this area have suggested that periodontal therapy during pregnancy can lessen the chance of adverse pregnancy outcomes. While the American Academy of Periodontology (AAP) has not yet received the opportunity to review the complete study findings, it continues to urge women to care for their periodontal health while pregnant, through regular tooth brushing and flossing, and routine visits to a periodontist to screen for periodontal disease. These study results demonstrate the need for additional research to clarify the potential impact that periodontal disease has on the risk of preterm births; and if needed, what periodontal treatment modalities are most effective in helping to prevent premature deliveries. As the organization representing over 8,000 dentists specially trained in the diagnosis, treatment and prevention of periodontal disease, the AAP is eager to analyze the complete study results, and provide women with accurate and effective recommendations on the management of periodontal disease during pregnancy. For more information, please contact the AAP’s Public Relations Office at 312-573-3242 or meg@perio.org.

Maintaining Healthy Teeth and Gums is a Wise Investment

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

CHICAGO—February 2, 2009—Faced with plummeting investments and an unsteady job market, many Americans are feeling the effects of the recent economic crisis. In fact, a recent study by the American Psychological Association found that over 80 percent of Americans rank money and the economy as significant causes of stress. And while chronic stress can lead to a host of health problems, including a weakened immune system and increased blood pressure, it can also take its toll on periodontal health. If left untreated, periodontal disease may result in even more serious, and potentially expensive, overall health complications. Stress and Your Smile According to David Cochran, DDS, PhD, President of the American Academy of Periodontology and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, stress can make an individual more susceptible to harmful habits that negatively impact oral health. “Stress may lead an individual to abuse tobacco or alcohol, and to possibly even neglect his or her oral hygiene. These lifestyle choices are known risk factors for the development of periodontal disease, which has been connected to several other chronic diseases, including heart disease and diabetes.” A study published in the February 2009 Journal of Periodontology (JOP) confirmed that stress may interfere with oral hygiene. In the study, 56 percent of participants self-reported that stress led them to neglect regular brushing and flossing. In addition, the hormone cortisol may also play a role in the connection between stress and gum disease. Chronic stress is associated with higher and more prolonged levels of cortisol; previous research has found that increased amounts of cortisol in the bloodstream can lead to a more destructive form of periodontal disease. “During periods of high stress such as what we are currently experiencing in this economic climate, individuals should seek healthy sources of relief such as regular exercise, eating a balanced diet, and getting adequate sleep,” says Dr. Cochran. “Doing so can help maintain a healthy mouth, and potentially help ward off other negative health concerns.” Preserve Your Gum Line, Improve Your Bottom Line Reducing stress in an effort to avoid gum disease may not only help sustain overall health, but it might also help your pocketbook as well. A study published in the November 2007 Journal of Periodontology found that preventing periodontal disease may be one way to help lower your total health care expenses. In the study, patients with severe periodontal disease had 21 percent higher health care costs as compared to those with no periodontal disease. Severe periodontal disease (periodontitis) involves bone loss and diminished tissue attachment around the teeth. And since past research has shown that periodontal disease may lead to other serious health conditions, striving to maintain oral health may help diminish the need to incur additional health care expenses, and ultimately help reduce overall health care spending. “In these stressful times I encourage my patients to pay even more attention to their teeth and gums,” says Dr. Cochran. “And in turn, since preventing gum disease may help reduce overall health care expenses, maintaining a healthy mouth may actually be a stress reliever in itself.” About Periodontists Periodontists, the dentists specially trained in the prevention, diagnosis and treatment of gum disease, recommend regular brushing and flossing and routine dental visits in order to maintain comprehensive oral health. If gum disease develops, consulting a periodontist is an effective way to determine the most appropriate course of treatment. To learn more about gum disease, locate a periodontist, or to find out if you are at risk for periodontal disease, visit perio.org or call (800) FLOSS-EM (800/356-7736). About the AAP The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide. For more information, contact the AAP Public Affairs Department at meg@perio.org or 312/573-3242.

Green Tea for Healthy Teeth and Gums

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

A recent study suggests that antioxidants in green tea may help reduce periodontal disease. By interfering with the inflammatory response of the body to periodontal bacteria, green tea may actually help promote periodontal health, and ward off further disease. (American Academy of Periodontology press release) CHICAGO—March 5, 2009—With origins dating back over 4,000 years, green tea has long been a popular beverage in Asian culture, and is increasingly gaining popularity in the United States. And while ancient Chinese and Japanese medicine believed green tea consumption could cure disease and heal wounds, recent scientific studies are beginning to establish the potential health benefits of drinking green tea, especially in weight loss, heart health, and cancer prevention. A study recently published in the Journal of Periodontology, the official publication of the American Academy of Periodontology (AAP), uncovered yet another benefit of green tea consumption. Researchers found that routine intake of green tea may also help promote healthy teeth and gums. The study analyzed the periodontal health of 940 men, and found that those who regularly drank green tea had superior periodontal health than subjects that consumed less green tea. Study Abstract * “It has been long speculated that green tea possesses a host of health benefits,” said study author Dr. Yoshihiro Shimazaki of Kyushu University in Fukuoka, Japan. “And since many of us enjoy green tea on a regular basis, my colleagues and I were eager to investigate the impact of green tea consumption on periodontal health, especially considering the escalating emphasis on the connection between periodontal health and overall health.” Male participants aged 49 through 59 were examined on three indicators of periodontal disease: periodontal pocket depth (PD), clinical attachment loss (CAL) of gum tissue, and bleeding on probing (BOP) of the gum tissue. Researchers observed that for every one cup of green tea consumed per day, there was a decrease in all three indicators, therefore signifying a lower instance of periodontal disease in those subjects who regularly drank green tea. Green tea’s ability to help reduce symptoms of periodontal disease may be due to the presence of the antioxidant catechin. Previous research has demonstrated antioxidants’ ability to reduce inflammation in the body, and the indicators of periodontal disease measured in this study, PD, CAL and BOP, suggest the existence of an inflammatory response to periodontal bacteria in the mouth. By interfering with the body’s inflammatory response to periodontal bacteria, green tea may actually help promote periodontal health, and ward off further disease. Periodontal disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth, and has been associated with the progression of other diseases such as cardiovascular disease and diabetes. “Periodontists believe that maintaining healthy gums is absolutely critical to maintaining a healthy body,” says Dr. David Cochran, DDS, PhD, President of the AAP and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio. “That is why it is so important to find simple ways to boost periodontal health, such as regularly drinking green tea—something already known to possess certain health-related benefits.” To learn more about gum disease, locate a periodontist or find out if you are at risk for periodontal diseases, visit www.perio.org, or call 800-FLOSS-EM (800/356-7736). About the AAP The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide. For more information, contact the AAP Public Affairs Department at meg@perio.org or 312/573-3242. * EDITOR'S NOTE: Representatives of the media may contact the AAP Public Affairs Department to receive a copy of the study Relationship Between Green Tea and Periodontal Disease. Abstracts of Journal of Periodontology articles are available to the public online. Full-text of studies may be accessed by AAP members and Journal subscribers or purchased online for $20.

Placement of Dental Implants Results in Minimal Bone Loss

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

A five-year follow-up study observed marginal bone remodeling occurs between implant placement and prosthesis placement, providing additional support for the effectiveness of dental implants to replace missing teeth. (American Academy of Periodontology press release) CHICAGO—May 11, 2009—Dental implants are frequently used as a replacement for missing teeth in order to restore the patient’s tooth function and appearance. Previous research demonstrates that the placement of a dental implant disrupts the host tissue in the area of the implant, so practitioners often focus their treatment planning to carefully maintain the patient’s bone and gum tissue surrounding the implant. A recent study published in the Journal of Periodontology found that the majority of bone remodeling occurred in the time between the implant placement and final prosthesis placement. Study Abstract* Subsequently, little mean bone change was observed in the five years following the implant placement, independent of type of restoration or implant length. The study, conducted at the University of Texas Health Science Center at San Antonio, evaluated 596 dental implants placed in 192 patients over the age of 18. Patients were screened for adequate oral hygiene and bone volume. Exclusion criteria included heavy smoking, chewing tobacco use, drug abuse, and untreated periodontal disease, amongst others. Study author Dr. David Cochran, DDS, PhD, Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, and President of the American Academy of Periodontology (AAP), believes that this study provides additional support for the use of dental implants to replace missing teeth. “As a periodontist, I am committed to saving my patients’ natural dentition whenever possible. However, the results of this study help further indicate that a dental implant is an effective and dependable tooth replacement option. Since the patient’s host tissue surrounding the dental implant largely remains unchanged in the five years following placement, the dental team can now focus on periodic assessment and treatment of other areas in the mouth as needed, and know that the implant is doing its job as a viable substitute solution.” A referral to a periodontist in your area and free oral health brochure samples including one titled "Dental Implants: Teeth That Look and Feel Just Like Your Own" are available by calling 800-FLOSS-EM or visiting the AAP's Web site at www.perio.org. About the AAP The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide. For more information, contact the AAP Public Affairs Department at meg@perio.org or 312/573-3242. * EDITOR'S NOTE: Representatives of the media may contact the AAP Public Affairs Department to receive a copy of the study A Prospective Multi-Center 5 Year Radiographic Evaluation of Crestal Bone Levels Over Time in 596 Dental Implants Placed in 192 Patients. Abstracts of Journal of Periodontology articles are available to the public online. Full-text of studies may be accessed by AAP members and Journal subscribers or purchased online for $20.

Healthy Gums and a Healthy Heart: The Perio-Cardio Connection

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

Newly released clinical recommendations encourage cardiologists to examine the mouth and periodontists to ask questions about heart health. (American Academy of Periodontology press release) CHICAGO—June 1, 2009—Cardiovascular disease, the leading killer of men and women in the United States, is a major public health issue contributing to 2,400 deaths each day. Periodontal disease, a chronic inflammatory disease that destroys bone and gum tissues that support the teeth affects nearly 75 percent of Americans and is the major cause of adult tooth loss. And while the prevalence rates of these disease states seems grim, research suggests that managing one disease may reduce the risk for the other. A consensus paper on the relationship between heart disease and gum disease was recently published concurrently in the online versions of two leading publications, the American Journal of Cardiology (AJC), a publication circulated to 30,000 cardiologists, and the Journal of Periodontology (JOP), the official publication of the American Academy or Periodontology (AAP). Developed in concert by cardiologists, the physicians specialized in treating diseases of the heart, and periodontists, the dentists with advanced training in the treatment and prevention of periodontal disease, the paper contains clinical recommendations for both medical and dental professionals to use in managing patients living with, or who are at risk for, either disease. As a result of the paper, cardiologists may now examine a patient’s mouth, and periodontists may begin asking questions about heart health and family history of heart disease. The clinical recommendations were developed at a meeting held earlier this year of top opinion-leaders in both cardiology and periodontology. In addition to the clinical recommendations, the consensus paper summarizes the scientific evidence that links periodontal disease and cardiovascular disease and explains the underlying biologic and inflammatory mechanisms that may be the basis for the connection. According to Kenneth Kornman, DDS, PhD, Editor of the Journal of Periodontology and a co-author of the consensus report, the cooperation between the cardiology and periodontal communities is an important first step in helping patients reduce their risk of these associated diseases. “Inflammation is a major risk factor for heart disease, and periodontal disease may increase the inflammation level throughout the body. Since several studies have shown that patients with periodontal disease have an increased risk for cardiovascular disease, we felt it was important to develop clinical recommendations for our respective specialties. Therefore, you will now see cardiologists and periodontists joining forces to help our patients.” For patients, this may mean receiving some unconventional advice from their periodontist or cardiologist. The clinical recommendations outlined in the consensus paper advise that periodontists not only inform their patients of the increased risk of cardiovascular disease associated with periodontal disease, but also assess their risk for future cardiovascular disease and guide them to be evaluated for the major risk factors. The paper also recommends that physicians managing patients with cardiovascular disease evaluate the mouth for the basic signs of periodontal disease such as significant tooth loss, visual signs of oral inflammation, and receding gums. While additional research will help identify the precise relationship between periodontal disease and cardiovascular disease, recent emphasis has been placed on the role of inflammation - the body’s reaction to fight off infection, guard against injury or shield against irritation. While inflammation initially intends to have a protective effect, untreated chronic inflammation can lead to dysfunction of the affected tissues, and therefore to more severe health complications. “Both periodontal disease and cardiovascular disease are inflammatory diseases, and inflammation is the common mechanism that connects them,” says Dr. David Cochran, DDS, PhD, President of the AAP and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio. “The clinical recommendations included in the consensus paper will help periodontists and cardiologists control the inflammatory burden in the body as a result of gum disease or heart disease, thereby helping to reduce further disease progression, and ultimately to improve our patients’ overall health. That is our common goal.” NOTE: A copy of The American Journal of Cardiology and Journal of Periodontology Editors’ Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease can be viewed online. To find out if you are at risk for periodontal diseases, take the Academy’s risk assessment test. Referral to a periodontist in your area and online brochure samples including one titled Ask Your Periodontist about Periodontal Disease and Heart Disease are available by calling 800-FLOSS-EM or visiting the AAP's Web site at www.perio.org. About the AAP The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide. For more information, contact the AAP Public Affairs Department at meg@perio.org or 312/573-3242.

AAP Supports the International Diabetes Federation Guideline on Oral Health for People with Diabetes

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

The guideline supports what research has already suggested: that management of periodontal disease can help reduce the risk of developing diabetes and also help people with diabetes control their blood sugar levels. (American Academy of Periodontology press release) CHICAGO—November 3, 2009—New clinical guidelines released by the International Diabetes Federation (IDF) emphasize the importance of periodontal health for people with diabetes. Diabetes affects approximately 285 million people worldwide, and this number is only expected to increase. The IDF is an organization of 200 national diabetes associations from 160 countries. The new IDF oral health clinical guideline supports what research has already suggested: that management of periodontal disease—which affects the gums and other supporting tissues around the teeth—can help reduce the risk of developing diabetes and can also help people with diabetes control their blood sugar levels. Studies have suggested there is a two-way relationship between diabetes and periodontal disease, and the IDF guideline outlines helpful guidance for health professionals who treat people living with and at risk for diabetes. The IDF guideline contains clinical recommendations on periodontal care, written in collaboration with the World Dental Federation (FDI), that encourage health professionals to conduct annual inquiries for symptoms of periodontal disease such as swollen or red gums, or bleeding during tooth brushing; and to educate their patients with diabetes about the implications of the condition on oral health, and especially periodontal health. “Everyone should maintain healthy teeth and gums to avoid periodontal disease, but people with diabetes should pay extra attention,” said Samuel Low, DDS, MS, Associate Dean and professor of periodontology at the University of Florida College of Dentistry, and President of the American Academy of Periodontology (AAP). “Periodontal disease triggers the body’s inflammatory response which can affect insulin sensitivity and ultimately lead to unhealthy blood sugar levels. Establishing routine periodontal care is one way to help keep diabetes under control.” In recognition of American Diabetes Month, the American Academy of Periodontology commends the International Diabetes Federation on the release of the Guideline on Oral Health for People with Diabetes, and supports its encouragement of continued collaboration and communication between diabetes and oral healthcare professionals. In addition to helping increase awareness about the importance of oral care for people with diabetes, Dr. Low believes the guideline presents more opportunities for medicine and dentistry to work together. “I know that these clinical recommendations will be helpful for those professionals who work with and treat people with diabetes. I also encourage the medical and dental communities to work together to provide the best possible care for our patients.” For more information on the link between diabetes and periodontal disease, or to speak with an AAP spokesperson, please contact the AAP’s Public Relations Office at 312-573-3242 or meg@perio.org. To learn more about gum disease, locate a periodontist, or to find out if you are at risk for periodontal disease, visit perio.org or call (800) FLOSS-EM (800/356-7736). About the American Academy of Periodontology The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

Dispelling Myths about Gum Disease: The Truth Behind Healthy Teeth and Gums

American Academy of Periodontology News Releases — Wed, 10 Mar 2010 06:06:47 +0000

The discrepancy between the prevalence of gum disease and the low levels of treatment can likely be blamed on a lack of understanding of the effect periodontal disease can have on overall health. (American Academy of Periodontology press release) CHICAGO—February 18, 2010—The American Academy of Periodontology (AAP) estimates that approximately three out of four Americans suffer from some form of gum disease – from mild cases of gingivitis, to the more severe form known as periodontitis. However, despite this prevalence, approximately only three percent seek treatment for their gum disease. With increasingly more research indicating that gum disease may be linked to several other diseases, including diabetes, heart disease and certain forms of cancer, maintaining healthy teeth and gums has become more important that ever. According to Samuel Low, DDS, MS, Associate Dean and professor of periodontology at the University of Florida College of Dentistry, and President of the American Academy of Periodontology, the discrepancy between the prevalence of gum disease and the lack of treatment can likely be blamed on a lack of understanding of the effect periodontal disease can have on overall health. “Patients do not always seek the periodontal care they require because they are not aware of the long-term and potentially dangerous implications of untreated gum disease,” says Dr. Low. “Unfortunately, there are a variety of myths surrounding periodontal disease and its repercussions.” In order to help distinguish between fact and fallacy regarding periodontal disease, the AAP has identified and addressed below some common misconceptions about oral health. Bleeding gums are not that big of a deal. Red, swollen and bleeding gums are an important sign of periodontal disease. If you notice bleeding while brushing or flossing, or when eating certain foods, you should schedule a visit with your dental professional to be evaluated for periodontal disease. Studies have shown that in addition to tooth loss, gum disease may contribute to the progression of other diseases, including heart disease and diabetes, so it is important that you begin treating periodontal disease as soon as possible. You don’t need to floss every day. Routine oral care, which includes brushing after every meal and before bedtime, and flossing at least once a day, is the best way to prevent gum disease. However, a recent survey estimates that only 13.5 percent of Americans floss each day. It is vital that you keep up with your daily oral care, and see a dental professional for a thorough check-up twice a year. If gum disease is diagnosed, a consultation with a periodontist, a dentist who specializes in treating periodontal disease, may be beneficial. A visit to the periodontist will be scary. Periodontists are gum disease experts. They have received three or more years of specialized training following dental school centered on the diagnosis, treatment and prevention of periodontal disease. Periodontists are equipped with the latest treatments and technologies, using innovative tools such as digital radiography, ultrasound technology, biomarker measurement and laser therapy to help make your visit more comfortable. A tooth lost to gum disease is a tooth lost forever. Gum disease is a major cause of tooth loss in adults. However, in addition to treating gum disease, periodontists are also experts in placing dental implants – a convenient and comfortable way to permanently replace missing teeth. A dental implant is an artificial tooth root that is placed into the jaw to hold a replacement tooth. Studies have shown that dental implants have a 98 percent success rate, and with proper care, allow you to speak, eat and smile with confidence. In fact, a survey conducted by the American Academy of Periodontology found that over 70 percent of respondents reported being “pleased” or “extremely satisfied” with the results of their dental implants. Poor oral hygiene is the only way to develop gum disease. Forgoing good oral hygiene can certainly contribute to the progression of gum disease, but there are a variety of other factors that can also impact your risk. For instance, tobacco use has been shown to greatly increase your chance of developing gum disease. Stress, poor diet, and even genetics, can also play a role in the health of your gums. To determine your risk of developing gum disease, the AAP offers a free online risk assessment test. For more information on common myths surrounding periodontal disease, or to speak with an AAP spokesperson, please contact the AAP’s Public Relations Office at 312-573-3242 or meg@perio.org. About the American Academy of Periodontology The American Academy of Periodontology (AAP) is the professional organization for periodontists – specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members world-wide.