NDA JOURNAL Winter 24 Volume 26, Issue 4 Official Magazine of the Nevada Dental Association and Component Societies A Peer Reviewed Journal
WINTER 24–25 NDA JOURNAL Editor’s Message Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD 2 Featured Articles In the Tiger’s Mouth: A History of Veterinary Medicine, Part 2 of 4 5 Federal Trade Commission Bans Noncompete Agreements 8 Vaccines and the Length of Our Lives 10 Experimental Formulation vs Vaccination... 9th Circuit Court of Appeals: NDAJ: Right; Pretty Much Everyone Else: Wrong 14 9th Circuit Court of Appeals Rules mRNA COVID-19 Jab is NOT a Vaccine Under Traditional Medical Definitions 16 Trust me…It’s good for you. Reprinted from the Winter 2012–13 NDA Journal 17 Community Water Fluoridation in 2024: A Nevada Dental Association Commentary 19 Community Water Fluoridation is Effective at Preventing Cavities 21 Reports NDA Executive Director Marianna Kacyra 22 SNDS President Christine Lemon, DDS 23 NNDS Executive Director Lori Benvin 25 Sections Event Calendars 26 Administrative Offices & NDA Committees 27 Nevada Dental Association 600 E. William Street, Ste 202 Carson City, NV 89701 PH 775-558-9404 FAX 702-255-3302 EMAIL info@nvda.org WEB www.nvda.org NDA Journal is published four times each year by the Nevada Dental Association and state component societies. All views expressed herein are published on the authority of the writer under whose name they appear and are not to be regarded as views of the publishers. We reserve the right to reduce, revise, or reject any manuscript submitted for publication. Materials: All articles, letters to the editor, photos, etc. should be sent to Daniel L. Orr II, DDS, via email to EditorNDA@nvda.org. All chapter and committee reports and business communications should be sent to Marianna Kacyra, Executive Director, Nevada Dental Association, 600 E. William Street, #202, Carson City, NV 89701. Ph: 775-558-9404. Materials may be reproduced with written permission. Subscription: Members receive each publication as a membership benefit paid by membership dues. Non-members may subscribe to the Nevada Dental Association Journal for $50 annually. Advertising Policy: All advertising appearing in the NDA Journal and other Nevada dental publications must comply with the advertising standards of the Nevada Dental Association and its component societies. The publication of an advertisement is not to be construed as an endorsement or approval by the publishers of the product or service being offered in the advertisement unless the advertisement specifically includes an authorized statement that such approval or endorsement has been granted. The publishers further reserve the right to cancel any and all contractual advertising agreements should an advertiser be engaged in litigation concerning their product or service, or should the product or service be in conflict with the standards of the NDA or its component societies. Advertising rates and specifications are available upon request. Contact, William Hutabarat, Big Red M, at 571-331-3361 or email william.hutabarat@bigredm.com. Mailing: Send address changes to: 600 E. William Street, #202, Carson City, NV 89701. © 2024 Nevada Dental Association Editor Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD EditorNDA@nvda.org Publisher Big Red M www.bigredm.com Design: Shelby Bigelow NDA JOURNAL
NDA Journal 2 Dr. Orr practices Anesthesiology and OMS in Las Vegas, is an Adjunct Professor (Surgery) at UNLV SM and Touro University SM (Jurisprudence), Professor Emeritus at UNLV SDM, and a member of the CA Bar and Ninth Circuit Court of Appeals. Editor’s Message Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD EditorNDA@nvda.org NDAJ Exclusive Back to the Polls, 2024 Edition Wanting to learn more about elections and election law, I am one of many to take the opportunity to volunteer as an election observer or actual worker the polls. The experiences have been time-consuming but enjoyable and educational. Others involved as volunteers or workers are uniformly polite, friendly, and helpful…a good crowd. This year, I enrolled with an attorney’s group to observe and chose the mail ballot processing venue. We were trained in election law and even received some CLE along the way. My first assignment was October 24 at the Clark County Elections facility in North Las Vegas. At the sign-in desk we were photo ID’ed (although that isn’t necessary for actual voters in Nevada), asked if we were with a group, watched an introductory video, signed some consents and disclaimers, and reviewed the rules, including infractions such as talking to workers and chit-chatting too much with fellow observers, either of which could result in being asked/told to leave. We were escorted everywhere including 5–6 primary stations: intake, signature verification, sorting, tray inspection, ballot duplication, tabulation, etc. Observing ballot processing was kind of like trying to understand dentistry without being a dentist. When I had my own mitral valve repair in 2017, my surgeon/comedian Dr. Rob Wiencek asked me if I wanted a bovine, porcine, or mechanical valve. I replied: “Rob, I’m a dentist, how would I know? How about just fix what is already there?” He did perfect a repair, so I’m not mooing, oinking, or clicking, and here I am today, better than ever CVS-wise, but still not knowing a lot about my procedure. Thank you again Dr. Wiencek.1 (Photo 1) Back at the facility, I did ask 3–4 questions which the main supervisor, another Dan, tried to answer near the end of my session. It felt good that Dan didn’t know all the answers. 1. In Ballot Duplication, what was contained in the three envelopes marked “Discard”? Dan was unsure but opined possibly defective ballots. 2.In sorting, how were ballots sorted (i.e., categorically)? Answer: “By precinct.” 3.In sorting, why were ballots sorted? Answer: “Not sure.” 4. What is the significance of the worker ID tag category “Minor,” as opposed to “DEM,” “REP,” or “IND”? Answer: “Minor indicates a minor party affiliation.” My overall impressions were that this was a terribly expensive, but feckless, attempt to create order from volitionally introduced chaos. I don’t plan on sending in a mail ballot unless that is the last resort, understanding there can be issues with live voting Photo 1. Cardiovascular Surgeon Dr. Rob Wiencek humorously asked the Editor, a dentist, about mitral valve repair recommendations.
Winter 24–25 www.nvda.org 3 Editor’s Message too. Originally very few, such as the military or out-of-state college students, requested and received mail-in ballots. Now, everyone in Nevada automatically receives one, requested or not. The intended recipients at my mailing address included three adult children, and an ex-wife, all living in other states or countries. But at least these Orrs are U.S. citizens, and still alive. Some political pundits cannot help feeling there is a lot of potential for error2,or even intentional duplicity.3 I still remember the day in November 2020 when I found U.S. Mail littering a street, including sample ballots and mail ballots. (Photos 2,3,4) A possible dental analogy might be that when a patient presents with one severely compromised tooth, we can often herodontically restore it to full function with better than ever esthetics. But if a patient walks in with the chaos of thirty-two nonfunctional and unrestorable incisors and masticators, a dentist can appear heroic by eliminating the problems all together. Separating the donts from the perio cures more periodontal disease in a few minutes than, for instance, my former UNLV SDM student and periodontist son-in-law Aaron Rawlings does in a week. (Photo 5) But, as those of the “total edentulation” movement, a negative sequel of the trendy “focal theory of infection”4 a hundred years ago found, patients tend to do better with healthy teeth in place. Perhaps the way to cure the ongoing mail ballot controversies is to wipe the slate clean, like dental surgeons do with total odontectomies? Even God apparently feels challenged with confronted with out-of-control chaos. Think of Noah’s Ark, wherein He started over from scratch, or Sodom and Gomorrah wherein He just forgot the whole thing. Perhaps there is a lesson there for we mortals dealing with chaos? Photo 2. » Photo 6. Loading docks 8, 9, 10, 11 at the Clark County mail ballot facility election day eve. Photo 3. Photo 4. Photo 5. Student Tim Orr, now an anesthesiologist, the Editor, and student Aaron Rawlings, now a periodontist, at UNLV SDM 2008
NDA Journal 4 My second shift was Monday evening before election day. I assigned myself to observe the loading docks (Photo 6) at the mail ballot facility and had a great time listening to Monday Night Football and then UNLV basketball as I sipped Diet Coke and had some peanuts in my Mini Cooper. I didn’t see anything fishy and appreciated the fact that the Clark County Police and the LVMPD (three vehicles) both arrived about 21:00 to monitor things. I observed the law enforcement observers for a while and decided I could sign out as they appeared to be set for the night. It is a valuable civic learning experience to work or observe at the polls. America has never been perfect, although the founding documents are singular in history in committing to the goal of the perfection of individual freedom and equal opportunity, not necessarily equal outcome, in the pursuit of happiness. Be that as it may, some will always shortsightedly aspire to oxymoronically “create” chaos (the natural result over time when wisdom and order is not incorporated into any project). Why do some choose to promote chaos? Simply put, in order to accumulate some temporary dominion and control, or power, over others. » Editor’s Message Table 1. The tens of millions of never before seen new votes in 2020 failed to appear in 2024. Speakers at the Poll Observer CLE training opined that the known presence of lawyer observers may be a powerful deterrent to illegal voting. Tis the season, so think football: offenses attempt to be orderly creators while defenses seek to be chaotic destroyers. The game is a lot like life on earth. If either side perfects its craft, the game as we know it is over. Let’s hope the altruistic and unconflicted (no personal empowerment at the expense of others) creators in our nation ultimately prevail. 0 References 1. Wiencek D, Healthcare Hero, https://www.youtube.com/watch?v=VK1s7ickOk, accessed 25 OCT 2024. 2. Orr D, See Photos 2,3,4 of US Mail, including mail-in ballots and Sample Ballots, found at Barnard and Oakey 14 NOV 2020. 3. Muth C, Nevada Secretary of State is Misleading Voters About Election Integrity, 20 OCT 2024, https://muthstruths.com/nevadasecretary-of-state-is-misleading-voters-about-election-integrity/, accessed 25 OCT 2024. 4. Orr D, Focal Tales, NDAJ 10:1, 4–6, Spring 2008.
Winter 24–25 www.nvda.org 5 Dr. Tina Brandon Abbatangelo is an associate professor in-residence at the University of Nevada Las Vegas School of Dental Medicine. She is a graduate of the University of Iowa College of Dentistry. She has earned an MS in public health and is continuing studies in Dental Public Health at UNLV School of Dental Medicine. She is a volunteer secretary for the Peter Emily International Veterinary Dental Foundation (PEIVDF) and the author of the children’s book Animal Dentistry Adventures with Dr. Tabby, Animal Dentist Extraordinaire. Tina Brandon Abbatangelo, DDS In the Tiger’s Mouth: A History of Veterinary Medicine, Part 2 of 4 by: Tina Brandon Abbatangelo, DDS MPH Abstract The discipline of dentistry includes most animals that have a masticatory system and have experienced contact and interaction with humans. This article provides an illuminating account of the historical development of animal dentistry, as well as outlining the future direction of the specialty. Animal dentistry has undergone a complex evolution, with pioneers in the field guiding the way for both dentists and veterinarians. It has transitioned from being a source of financial dependence through equine dentistry to include the dental care of household pets. Through the examination of several animal dentistry cases, we will uncover both the commonalities and distinctions. Animal dentistry is an essential specialty in veterinary medicine that is experiencing growth both economically and in its integrative approach to treating the entire body and its systems. Part 2 Veterinary Dentistry as a Specialty Dentistry is an essential addition to any veterinary practice. Key elements are prevention and general health. All systemic illnesses are connected to one another, and this includes how they affect the mouth. Not only do domestic animals benefit from advancements in dentistry, but also captive and exotic species. One of the college’s long-term teaching objectives was to provide comprehensive dental treatment for domestic, exotic, companion, equestrian, and livestock animals. For veterinarians to become board- certified in the field of dentistry, additional training is required. This parallels human dentistry training when a general dentist seeks to specialize in one of the twelve ADA-recognized specialties. The considerable distinction in training is the layered knowledge of most disciplines of dentistry, including operative, oral maxillofacial surgery, endodontics, oral pathology, radiology, orthodontics, periodontics, and dental anesthesia. Their training must also encompass a full understanding of numerous animal species, both domestic and exotic, and common oral pathologies. Full-mouth series radiography, fullmouth probing, and a thorough clinical examination are taken to make the correct diagnosis. Like human dentistry, the main goals of veterinary oral health are to promote overall health through diagnosis, prognosis, prevention, treatment, and management. There exist notable distinctions and parallels with respect to the oral cavity among various animal species and humans. A painful analogy is the detrimental effect that acute or chronic dental pain can have on an individual’s quality of life. Sadly, the only means by which animals can communicate their pain is by refusing to eat, becoming unpredictable in behavior, or losing interest in social relationships. From the advances in veterinary dentistry over the last twenty years, the American Veterinary Medical Association currently recognizes veterinary dentistry as a specialty. The American Veterinary Dental College is the governing body for the specialty, and it establishes the rules and conditions for certification. The specialty » Featured Article
NDA Journal 6 certification in dentistry requires completing 3–5 years of training. Veterinary Dentistry as a Specialty Domestic dogs and cats are the most common animals to be seen in a veterinary clinic. Periodontal disease, dental caries, and oral cancers are some of the major pathologies found in their oral cavities, especially those of the age of seven.18 FORL (feline odontoclastic resorptive lesions) is a common condition among domestic cats. The precise etiology of FORL still remains unknown yet the mechanism of progression is well understood. Suggested causes include inflammation of the soft tissue around the tooth, damage to the enamel or cementum, predisposition resulting from the anatomical structure of cat teeth, or excessive vitamin D intake.19 Pathogenesis occurs when odontoclasts cause cementum and dentin resorption. Bone-like tissue replaces the resorbed tissue. FORL could occur on any root surface of the tooth.19 The most seriously affected tooth is the mandibular third molar, and the progression of the disease is typically symmetrical. Alterations in behavior, hypersalivation, and anorexia are clinical signs. Certain cats exhibit no clinical symptoms. When resorption penetrates the pulp, the disease is painful. A comprehensive clinical examination encompasses a radiological assessment of every tooth while the animal is completely sedated. The intent of every treatment is to alleviate the cat’s pain and discomfort. At present, the available options for treatment consist of coronal amputation and tooth extraction. Tooth extraction is the most recommended treatment option.19 Toy breeds are notorious for periodontal disease. This case shows clinical and radiographic evidence of bone loss. Treatment recommended is extractions. A soft diet after the extractions will also be recommended. Black Labrador with a carious lesion penetrated the pulp on the fourth mandibular premolar. The tooth was treated with a root canal and full metal crown. Extraction was another option; however, the owner wanted the most ideal treatment for his canine companion. This case was performed by Dr. Brian Hewitt, a board-certified veterinary dentist and Dr. Tina Brandon Abbatangelo. 0 References (continued from part 1 numerically) 18. Holmstrom, S. E. (2018). Veterinary Dentistry: A Team Approach E-Book. Elsevier Health Sciences. 19. Myhre, S. S., & Ueland, K. (2009). Feline odontoclastic resorptive lesions-a review of the disease and description of three cases. Norsk Veterinærtidsskrift, 121(8), 655-661. » Featured Article
Winter 24–25 www.nvda.org 7 Section Header Featured Article
NDA Journal 8 Federal Trade Commission Bans Noncompete Agreements by: Steph Weber, April 24, 2024 The Federal Trade Commission (FTC) voted Tuesday to ban noncompete agreements, possibly making it easier for doctors to switch employers without having to leave their communities and patients behind. But business groups have vowed to challenge the decision in court. The proposed final rule passed on a 3–2 vote, with the dissenting commissioners disputing the FTC’s authority to broadly ban noncompetes. Tensions around noncompetes have been building for years. In 2021, President Biden issued an executive order supporting measures to improve economic competition, in which he urged the FTC to consider its rulemaking authority to address noncompete clauses that unfairly limit workers’ mobility. In January 2023, per that directive, the agency proposed ending the restrictive covenants. While the FTC estimates that the final rule will reduce healthcare costs by up to $194 billion over the next decade and increase worker earnings by $300 million annually, the ruling faces legal hurdles. U.S. Chamber of Commerce president and CEO Suzanne P. Clark said in a statement that the move is a “blatant power grab” that will undermine competitive business practices, adding that the Chamber will sue to block the measure. The FTC received more than 26,000 comments on noncompetes during the public feedback period, with about 25,000 supporting the measure, said Benjamin Cady, JD, an FTC attorney. Cady called the feedback “compelling,” citing instances of workers who were forced to commute long distances, uproot their families, or risk expensive litigation for wanting to pursue job opportunities. For example, a comment from a physician working in Appalachia highlights the potential real-life implications of the agreements. “With hospital systems merging, providers with aggressive noncompetes must abandon the community that they serve if they [choose] to leave their employer. Healthcare providers feel trapped in their current employment situation, leading to significant burnout that can shorten their [career] longevity.” Commissioner Alvaro Bedoya said physicians have had their lives upended by cumbersome Featured Article
Winter 24–25 www.nvda.org 9 noncompetes, often having to move out of state to practice. “A pandemic killed a million people in this country, and there are doctors who cannot work because of a noncompete,” he said. It’s unclear whether physicians and others who work for nonprofit healthcare groups or hospitals will be covered by the new ban. FTC Commissioner Rebecca Slaughter acknowledged that the agency’s jurisdictional limitations mean that employees of “certain nonprofit organizations” may not benefit from the rule. “We want to be transparent about the limitation and recognize there are workers, especially healthcare workers, who are bound by anticompetitive and unfair noncompete clauses, that our rule will struggle to reach,” she said. To cover nonprofit healthcare employees, Slaughter urged Congress to pass legislation banning noncompetes, such as the Workforce Mobility Act of 2021 and the Freedom to Compete Act of 2023. The FTC final rule will take effect 120 days after it is published in the federal register, and new noncompete agreements will be banned as of this date. However, existing contracts for senior executives will remain in effect because these individuals are less likely to experience “acute harm” due to their ability to negotiate accordingly, said Cady. Before the federal ban, several states had already passed legislation limiting the reach of noncompetes. According to a recent article in the Journal of the American College of Cardiology, twelve states prohibit noncompete clauses for physicians: Alabama, California, Colorado, Delaware, Massachusetts, Montana, New Hampshire, New Mexico, North Dakota, Oklahoma, Rhode Island, and South Dakota. The remaining states allow noncompetes in some form, often excluding them for employees earning below a certain threshold. For example, in Oregon, noncompete agreements may apply to employees earning more than $113,241. Most states have provisions to adjust the threshold annually. The District of Columbia permits 2-year noncompetes for “medical specialists” earning over $250,000 annually. Indiana employers can no longer enter into noncompete agreements with primary care providers. Other specialties may be subject to the clauses, except when the physician terminates the contract for cause or when an employer terminates the contract without cause. Although the AMA does not support a total ban, its House of Delegates adopted policies last year to support the prohibition of noncompete contracts for physicians employed by forprofit or nonprofit hospitals, hospital systems, or staffing companies. The American Hospital Association, which opposed the proposed rule, called it “bad policy.” The decision “will likely be short-lived, with courts almost certain to stop it before it can do damage to hospitals’ ability to care for their patients and communities,” the association said in a statement. To ease the transition to the new rule, the FTC also released model language for employers to use when discussing the changes with their employees. The NDAJ thanks Medscape for this work. 0 Featured Article
NDA Journal 10 Vaccines and the Length of Our Lives by: David Bell, MD* The commercial imperative to extract money from human bodies is playing havoc with medical education, and the body of knowledge through which the medical professions operate. Nowhere is this more apparent than in the field of vaccines, and their place in determining the length of our lives. The History of Living Longer As a medical student, I was taught that the reason we in wealthy countries now live far longer than our forebears was improvements in living conditions, sanitation, and nutrition. We don’t walk through sewage and horse dung each day, eat fly-blown meat, drink water from below the nearest latrines, or sleep eight in a room on rancid bedding. We get beaten less often and have more leisure time. Antibiotics also helped but came after most of these gains had been achieved. Most vaccination came even later, mopping up some residual mortality in ‘vaccine-preventable diseases.’ This was all stated in a lecture hall of 300 medical students, with the relevant data to back it up, and accepted as fact. Because for wealthier countries it was, and is, undeniably true. I recently asked a small group of students the major reasons for improved life expectancy and was told “vaccination.” In a subsequent session, I showed some of the graphs laid out below. The students were shocked and asked where I obtained this information. It was actually fairly difficult to find. I remember searching 20 years ago and readily finding it on the web. In 2024, it took a lot of sifting through information explaining how vaccinations have apparently saved humanity, and how those repeating what I was taught as a student were a subversive element undermining the greater good, spreading misinformation or similar daft claims. We have certainly not progressed. This does not mean vaccines are not a great idea. Providing some immunity before an infection can mitigate much of its harm by giving the body a head start in fighting back. It just means their usefulness must be understood in context, as must their harm. Somewhat strangely, discussion of vaccines has become increasingly controversial within the medical establishment. It is as if an Inquisition has been imposed over the profession, seeking out anyone still prioritizing calm rational thought over a dogma dictated from above. However, if truth and calm discussion can form an anchor for policy, vaccination will be more effective. The charts shown here, from Australia, the United States, and England, reflect those of other wealthy countries. The same findings are reflected in various published papers. Facts are facts, even if they may with time become harder to find, buried under Big Search algorithms to keep us safe. They remain facts even if medical students are taught to believe alternate realities. Such false teaching, coupled with large financial incentives, drive their desire to ensure children be ‘fully vaccinated’ according to their country’s childhood schedule. They increasingly believe a lie, undeniable misinformation, that this is why most children in our countries now grow up without experiencing the death of a friend or sibling. Vaccines in Context Vaccination probably had a major role in the elimination of smallpox. We cannot, of course, be absolutely sure, as there was no control group. Smallpox caused outbreaks that decimated populations isolated for thousands of years from the virus, such as Native Americans, where a vaccine would have made a massive difference. However, smallpox also had the hallmarks of a disease that might actually disappear through good public health education and improved living standards; it lacked an animal reservoir, required close contact with body fluids to spread, and was usually easy to recognize. It is probable that the vaccine considerably accelerated its decline, especially in poorer countries. Measles is similarly interesting. As the graphic shows, most decline was long before mass vaccination. Like whooping cough, mortality was probably partly reduced through the advent of oxygen therapy, but mainly people just appear to have become less susceptible to its complications. Featured Article This does not mean vaccines are not a great idea. Providing some immunity before an infection can mitigate much of its harm by giving the body a head start in fighting back. It just means their usefulness must be understood in context, as must their harm.
Winter 24–25 www.nvda.org 11 It could nonetheless be a devastating disease, which decimated isolated, immunologically naïve populations in the Pacific Islands and elsewhere that had no history of contact, and still causes avoidable child death in low-income countries today. Measles deaths are often associated with micronutrient malnutrition, such as vitamin A deficiency, and fixing that would also address many other health risks. This used to be emphasized 30 years ago. However, the measles vaccine is also very effective at stopping measles deaths in susceptible populations. It has very little impact on mortality in wealthy countries where it mainly stops infection and annoying sickness, as few kids are so micronutrient-deficient to be susceptible to very severe diseases. It is so good at stopping actual infection that mandates for measles vaccines that some countries impose are more about authoritarianism than public health. If you don’t want your child to risk measles and decide that vaccination is a lesser risk, you can have your child vaccinated. Your child is now protected from those who are unvaccinated, so there should be no interest in mandating it for them. Rational free people could live with that. Hepatitis B and HPV vaccination (for Human Papilloma Virus) are two further curiosities. We schedule Hep B vaccination on the first day of life, even though it is mainly spread in Western countries through sexual contact and intravenous drug use. If the parents are not infected (and all mothers are screened), then there is not really a risk until the late teenage years, when the person can make their own informed choice. For a child born in a country with 30% Hepatitis B positivity rates and poor healthcare, the risk-benefit calculation may produce a different result. Dying of liver failure or liver cancer is not pleasant. The HPV vaccine, intended to prevent cervical cancer, has a complicated picture. It will have limited mortality impact in Western countries where cervical cancer mortality has already declined through regular screening. Elsewhere the situation is very different, with over 300,000 women dying annually from this agonizing disease, mostly in regions such as sub-Saharan Africa where only about 12% are screened. This is not through choice but because screening is poorly accessible. As development of cancer can take about 20 years after HPV infection, we must also rely on (reasonable) assumptions about causality when calculating benefits. So, the equation clearly varies between women. Calculating risk versus benefit in order to ensure clear informed consent (or even medical ethical competency) would require consideration of age, behavior, access to screening, and adverse event rates. To know adverse event rates, a comparison would logically be necessary between the vaccine and something neutral like saline (rather than other vaccine constituents). Because this is still awaited, women should of course be informed of this data gap. Therefore, a blanket policy on HPV vaccination would be illogical. The story of diphtheria suggests that medical management may have had a major role in its decline. The decline coincided with the introduction of antibody therapy (anti-toxin), and later decline with the toxoid vaccine. However, it also coincided with the decline of other respiratory diseases of childhood that did not have such interventions. So, we simply cannot be sure. Tetanus toxoid may also have had an impact, especially for people at higher risk, such as plumbers and farmers. However, accountants no longer navigate dung-paved streets on the way to the office and this general cleaning up of the environment will have driven much of the change. For business reasons that are slightly unclear, boosters are available only combined with diphtheria and pertussis vaccines in many Western countries, which adds nothing to an adult’s benefit but adds to their risk. It’s hard to claim safety and benefit are the main drivers in the face of such an anomaly. Knowing What We Don’t Know All vaccines also have adverse effects. While not discussed here, they are real, and I know people whose health was wrecked by vaccination. Assessment of risk is difficult as no childhood vaccines on the US schedule have been through a true placebo-controlled trial—they are usually compared against the rest of the contents of the vial (chemicals such as adjuvants and preservatives but lacking the antigen Featured Article »
NDA Journal 12 or inactivated virus—a mixture that may be the cause of most of the side effects) or against another vaccine. By doing this, they can be shown to be no worse than the comparator, which would be fine if we actually had decent placebo-controlled trials of the comparators. Most doctors who prescribe vaccines almost certainly don’t know this. (There is a good, evidence-based explanation of this issue which is well worth reading.) Most doctors probably also pay little attention to the lack of trials determining the effect of giving dozens of doses of immune-stimulating adjuvants and preservatives, including aluminum salts, to growing children across their formative years. It is likely to be relatively harmless to many children, but harmful to some, as biology tends to work that way. However, if the disease that it addresses is hardly ever severe, then that ‘some’ can become very significant. Each ‘some’ is a child whose parents are trying to do the right thing and trusting the medical establishment that this is indeed being done. None of this would be new to a lot of people, as interest in vaccines and their harms and benefits is growing. However, most doctors performing vaccinations are probably unaware of much of the above, especially those graduating in the past couple of decades. If they are aware, they will likely be scared to discuss it as this would risk being labeled a “vaccine denier” or similarly childish term or seen as promoting “vaccine hesitancy.” Vaccine hesitancy is what we once referred to as informed consent (or thinking before doing). After World War II, we decided that informed consent was essential for ethical medicine. Now, the World Health Organization considers such independent thoughts a particularly dangerous threat to their interests and those of their sponsors. Many recently trained doctors would consider the lecture I attended 40 years ago a public health risk, and the facts we were shown ‘misinformation.’ They will, at least in the U.S., also graduate with massive debt and be quite dependent on the subsidies they can receive from medical insurers, which include offering or giving vaccinations. This is why they can be so dismissive of intelligent people who spend time reading up on, and questioning, such things. They are not being aggressive or intentionally batting for Big Pharma; they are just so indoctrinated in the selling of these health commodities, and so financially and professionally dependent on this being the best course, that they are unable to articulate an independent, rational, evidence-based stance. Navigating a Rational Path To understand the vaccination issue, the public needs to understand that the medical and public health professions have lost their ability to reason. They are experts in repeating what they were taught, but not in deciphering reality. There are also fanatics and dogmatic people on the other side of the vaccine divide that can see the harms, but not the good. They downplay a few hundred thousand cervical cancer deaths per year and have not witnessed the gut-wrenching sight of a baby dying of tetanus in a low-income country with no ability to address her pain. They have not had to send a rabies sufferer home to die because there is simply nothing the local medical system can do for them once they are symptomatic. On vaccination policy, the public mostly needs to go it alone. Understand there are real risks and real benefits, like any pharmaceutical. Understand that the main reason why we don’t die from many of the infectious diseases that we used to has little to do with vaccination. » Featured Article Listen to a doctor, then ask them some pointed questions to ascertain whether they are looking at your child in context and weighing both sides or simply reciting a script. When the benefits clearly outweigh the risks, vaccines make sense. They are a foolish idea when the opposite applies. It’s difficult to navigate the information out there, but the public must do so until the medical establishment frees itself from the shackles of its sponsors and catches up. Everyone should be hesitant to have stuff injected into them for commercial profit. We should hesitate more when the person injecting it is also rewarded for their compliance. Doctors should be hesitant about injecting chemicals and metal salts into anyone unless they have strong expectations of net benefit. With vaccines, as with antibiotics and almost any other pharmaceutical, sometimes they will have and sometimes they won’t. Obviously, governments should not be mandating the injection of commercial chemicals as a requirement to participate in society—that would be ridiculous. A state can never make such individual cost-benefit assessments, and in a democracy, we certainly don’t pay the government to own and direct our bodies. This is all so obvious, and in line with conventional evidence-based practice, that you really wonder what all the fuss is about. 0 *David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. David is a former medical officer and scientist at the World Health Organization (WHO), Programme Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, WA, USA. The NDAJ thanks the author and Brownstone Institute for permission to republish this October 2024 work.
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NDA Journal 14 Experimental Formulation vs Vaccination... 9th Circuit Court of Appeals: NDAJ: Right; Pretty Much Everyone Else: Wrong by: Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD It is sad that circumspect health professionals have had to endure regulatory retribution, including loss of licensure, civil suits, and even criminal prosecution1,2 for being right. But, that is the consequence of allowing federal and state governments, law enforcement, and regulators to decide optimal health care, rather than honest, unconflicted by payola, doctors. We are speaking about the disastrous and toxic reflexive response to the pretty bad cold going around since November 2019, the one called COVID-19. Millions of Americans and others worldwide have been coerced one way or another into injecting one or more of the experimental formulations into their bodies. We were lied to, by virtually all the above entities, via an unethical and compliant mainstream media, about the formulations’ safety and efficacy. In fact, none of experimental drugs were safe, nor effective, except in producing a myriad of complications, including innumerable, and counting as the experiment continues, deaths. Many people, including doctors, didn’t take the time to critically analyze the propaganda and simply went along with opinions they thought they could trust. The now discredited advisors include healthcare-oriented entities such as the AMA, multiple specialty organizations such as the American College of Obstetrics and Gynecology3,4,5 the WHO, the CDC, hospitals, universities, state licensing boards, you name it. It was very difficult to find legitimate health professional related groups that one could trust, such as the reliable American Association of Physicians and Surgeons (AAPS).7,8,9,10 The result of the ubiquitous legerdemain is a societal mistrust of formerly, pre-COVID, trusted sources. The loss of credibility for the health professions has been devastating, resulting in a hesitancy to follow even routine recommendations from doctors at this time. Downstream entities such as city school boards, universities, churches, city councils, clubs, again there is a virtually endless list here, all became tyrannical as they tried to convince force citizens to acquiesce. The Journal has documented all this over the past few years.11,12,13,14,15,16,17,18,19,20,21,22,23,24,25 “Society’s reaction to the perceived viral threat may be much more problematic than the viral threat itself.” NDAJ Spring 2020 Gratifyingly, the 9th Circuit Court of Appeals agrees with the NDAJ’s posture in a contentious case, the Health Freedom Defense Fund et.al. v. the Los Angeles Unified School District. The Court ruled that the mRNA COVID-19 injections do not qualify as vaccines under traditional definitions. One element of the case was that, after 250 years of understanding, on September 01, 2021 the CDC unilaterally changed the definition of vaccine. As the Journal reported, the historical and truthful definition of a vaccine was an agent that provides immunity to a specific disease. For months, individuals had pointed out that the experimental formulations did not prevent anything, contrary to the manufacturers’ claims. The CDC then simply changed the definition of vaccine to an agent that stimulates the immune system. That only fooled those that were not paying attention. If a disgruntled pro-experimental drug true-believer slugged an NDA Member in the arm, that would stimulate the Member’s immune system, thus making the slug a CDC certified “Society’s reaction to the perceived viral threat may be much more problematic than the viral threat itself.”—NDAJ Spring 2020 Featured Article
Winter 24–25 www.nvda.org 15 Featured Article vaccine. But, like the promoted experimental formulations, the slug wouldn’t do anything to fight a cold and could have awful side effects. One gratifying element of all the nonsense is that of all the health professions, dentistry was the most resistant to the unconsented experiments. The Journal is pleased about the profession’s diagnostic and therapeutic logic and determination to follow truth. Rest assured though; it is certain the tyrants will be back with another version of healthcare related misinformation sooner than later. We’ll have the opportunity to resist the lies again. Fight On! 0 References 1. Orient J. NY Threatens Prison for Vaccine Refusal. NDAJ, 8–9, 22:1, 2020. 2. MIPS. Australian Doctors Have Been Warned They Are Obligated to Follow Public Health Messages. NDAJ, 24:2, 4, 2022. 3. CDC, American College of OB/GYN Tout Safety of Vaccines, NDAJ, 4, 23:3, 2021. 4. Trigoso E, Epoch. COVID Vaccines Increase Fetal Abnormalities Hundredfold. NDAJ, 12–13, 24:2, 2022. 5. Redshaw, M. Government Gave Millions to American College of Ob/GYN to Promote COVID Vaccines. NDAJ, 25:4, 8–10, 2023. 6. Project Veritas. Report on Pfizer Protocols. NDAJ, 6, 25:1, 6, 25:3, 2023. 7. Orient J. Should We Panic Over the Measles Outbreaks? NDAJ, 6-9, 22:1, 2020. 8. Dobken J. Bioethics and COVID-19. AAPS, NDAJ, 14–17, 22:2. 9. Merritt L. AAPS, The Treatment of Viral Diseases. NDAJ, 6-13, 23:1, 2021. 10. Orient J. AAPS, U.S. Pandemic Response. NDAJ, 4–15, 23:2, 2021. 11. Orr D. Kane’s Caution. NDAJ, 2–4, 22:1, 2020. 12. Orr D. Johnny Carson, TP, and Memories of Woodstock. NDAJ, 2–5, 22:2, 2020. 13. Sullivan W. Social Distancing is Snake Oil, Not Science. NDAJ, 9–10, 22:2, 2020. 14. Mayor Carolyn Goodman, Mayor Oscar Goodman, Mayor John Lee. NDAJ, 6–7, 22:2, 2020. 15. Orr D, What Impact has COVID-19 had on Dental Employment and Patient Services? NDAJ, 2–3, 22:3, Fall 2021. 16. CDC Changes the Definitions of Vaccine and Vaccination, NDAJ, 4, 22:3, 2021. 17. Orr D. Inaugural NDAJ Casey Stengel Award NCAA College World Series Co-Champions, NDAJ, 14–16, 22:3, 2021. 18. Orr D. Unmasking Masks, or Vectors Trump Barriers. NDAJ, 2-5, 22:4, 2021. 19. Huffman R. Primum Non Nocere. NDAJ, 5–8, 23:4, 2022. 20. Orr D. FDA Challenges Definition of Vanilla Ice Cream. NDAJ, 2–3, 24:1, 2022. 21. Malone R. Global COVID Summit, Crimes Against Humanity, NDAJ, 7–8, 24:2, 2022. 22. Athrappull N. Masks Cause Headaches, Itching, Lower Oxygen Intake. NDAJ, 9–10, 25:2, 2023. 23. Hulscher N, et.al. A Systemic review of Autopsy Findings in Deaths After COVID Vaccination. NDAJ, 25:3, 8, 2023. 24. Orr D. Ivermectin Legal Update. NDAJ, 25:2, 10, 2023. 25. Hannan D. Sweden Showed Lockdowns Were Worse Than Useless, NDAJ, 25:2, 12–13, 2023. 26. 9th Circuit Court of Appeals. https://law.justia.com/cases/federal/appellatecourts/ca9/22-55908/22-55908-2024-06-07.html, 07 June 2024. Accessed 08 June 2024. 27. Riedel S. Edward Jenner and the history of smallpox and vaccination. NDAJ, 24:4, 8–13, 2022. 28. Orr D. Dentists, Dental Students Worldwide resistant to COVID Injections. JADA, 8, 24:1, 2022. Many people, including doctors, didn’t take the time to critically analyze the propaganda and simply went along with opinions they thought they could trust.
NDA Journal 16 9th Circuit Court of Appeals Rules mRNA COVID-19 Jab is NOT a Vaccine Under Traditional Medical Definitions by: Jim Hᴏft* The United States Court of Appeals for the Ninth Circuit has delivered a seismic decision that could reshape public health policy across the nation. In a contentious case involving the Health Freedom Defense Fund and other plaintiffs versus the Los Angeles Unified School District (LAUSD), the court has declared that mRNA COVID-19 injections do not qualify as vaccines under traditional medical definitions. The case revolved around the LAUSD’s COVID-19 vaccination policy, which required all employees to be fully vaccinated against COVID-19 by a specified deadline. The plaintiffs argued that the district’s vaccine mandate infringed upon their fundamental right to refuse medical treatment, as the mRNA injections do not prevent the transmission of COVID-19 but merely mitigate symptoms for the recipient. The court’s opinion, penned by Circuit Judge R. Nelson and supported by Judge Collins, asserts that the mRNA shots, marketed as vaccines, do not effectively prevent the transmission of COVID-19 but merely reduce symptoms in those who contract the virus. This crucial distinction undermines the foundational premise of the vaccine mandates enforced by various governmental and educational institutions. Judge Nelson pointed out that the mandate was inconsistent with the Supreme Court’s century-old ruling in Jacobson v. Massachusetts, a case that upheld the state’s right to enforce smallpox vaccinations due to their proven effectiveness in preventing disease spread. In contrast, the mRNA COVID19 shots do not offer such public health benefits, thus failing the criteria established by Jacobson. The ruling points out that traditional vaccines are designed to provide immunity and prevent transmission, which is not conclusively proven in the case of mRNA COVID-19 shots. The Gateway Pundit previously reported that the Centers for Disease Control and Prevention (CDC) had modified the definition of “vaccine” to include the mRNA shots. So, look at what the CDC did. Here’s the definition the CDC used on 26 August 2021: Vaccine–“a product that stimulates a person’s immune system to produce immunity to a specific disease.” Vaccination–“the act of introducing a vaccine into the body to produce immunity to a specific disease.” Rather than admit the COVID-19 vaccine is not working as advertised, the CDC took a page out of Orwell’s 1984 and opted for new spin language. Here is the new definition: Vaccine–“a preparation that is used to stimulate the body’s immune response against diseases.” It can be recalled that Pfizer’s President of International Developed Markets, Janine Small, admitted in an EU hearing that the vaccine had never been tested on its ability to prevent transmission, contrary to what was previously advertised. Judge Collins, in a concurring opinion, highlighted that compulsory medical treatments for individual health benefits infringe upon the fundamental right to refuse such treatments. This perspective aligns with the constitutional principles protecting personal liberty against unwarranted governmental intrusions. 0 *Jim Hoft is the founder and editor of The Gateway Pundit, was awarded the Reed Irvine Accuracy in Media Award in 2013, and is the recipient of the Breitbart Award for Excellence in Online Journalism from the Americans for Prosperity Foundation in May 2016. The NDAJ appreciates permission to reprint this work. Featured Article
Winter 24–25 www.nvda.org 17 Winter 2012–2013 www.nvda.org 5 Editor’s Message Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD editornda@nvda.org Dr. Orr practices Oral & Maxillofacial Surgery in Las Vegas, is a Clinical Professor of Surgery & Anesthesiology for Dentistry at UNSOM, Professor and Director of OMS at UNLV SDM, and is a member of the California Bar. He can be reached at editornda@nvda.org “Perhaps one of you gentlemen would mind telling me just what it is outside the window that you all find so attractive…? Cartoon reprinted with permission Featured Article Reprint Trust me… It’s good for you. There is no question that if my community’s water supply had been fluoridated, Dr. Stratico would have had much less opportunity to treat carious lesions in my own A, B, G, H, I, J, S and T. He restored as necessary, with functional mercury alloy amalgam, every deciduous molar that had the temerity to erupt into my mouth, where frosted flakes regularly competed with chocolate bars for nutritional supremacy. If given the option of drinking fluoridated water with the promise that fewer cavities would be filled, I would have voted “yes” as a child. In dental school, the knowledge about the benefits of fluoridated community water supplies are, like fluoride into teeth, dutifully absorbed into student cerebra. The degree of altruism involved in organized dentistry’s support for the elimination of so many profitable restorations via fluoridation has likely prompted even St. Apollonia to smile perfectly resurrected teeth from her saintly sphere, even if debt ridden dental students get just a bit concerned about lost MOD revenue. Who couldn’t help but wonder though, if fluoridation is such a great idea, why have so many voters been opposed to it over the years and even during the recent presidential election?1 After reviewing the dental school dogma (fluoride is naturally occurring, will be carefully monitored, etc.), those dentists in the know often opine that anyone who doesn’t agree with fluoridation has to be irrational to some degree. A problem is that some of the opposition, a few dentists included, who warn of fluoride-related cancer, CNS, orthopedic, or renal pathology, don’t sound that illogical. Parents probably notice that dentists now advise that children drinking fluoridated water need to be careful with the use of fluoride toothpaste, prescriptions, trays (don’t swallow!) and other sources of the second most attractive (chlorine is first) oxidizer. »
NDA Journal 18 Some may recall an inhalational anesthetic, penthrane. Kids liked penthrane because it smelled like Juicy Fruit gum. But anesthesiology residents were warned to be judicious when administering methoxyflurane, as penthrane is generically known, because its metabolites include fluoride, which was particularly troublesome in patients who possessed kidneys and livers. Dentist anesthesiology residents couldn’t help wondering what would happen metabolically in our pediatric renal patients who might also metabolize fluoride from other sources in addition to that mandated by the government in the community water. Methoxyflurane use was largely discontinued in the mid-1970s, in large part because of fluoride issues. In spite of views expressed in popular media such as the 1964 movie Dr. Strangelove, fluoridated water is not likely a Communist plot to exert mind control. However, many creators of film, literature, television, music, etc. have suggested, theoretically tongue in cheek (humorous, not masticatory), a potential use for government prescribed psychogenic medication administration by means of community water supplies. Interestingly, we now have a very real, very scientific, suggestion that we should consider medicating water with another naturally occurring element, lithium. Studies, initially reporting about communities in Japan and Austria, found up to a 15% decrease in suicide in areas with naturally occurring lithium in the water.2 Further, lithium has been found helpful in Alzheimer disease. Anecdotal stories about towns with lithium laced “happy water” are abundant. Dentist anesthesiology residents were also warned about psychiatric patients who had been prescribed lithium and were prone to complications of electrolyte imbalance and of the cardiovascular system secondary to concomitant anesthesia administration.3 The University of Arizona’s Arizona Water Resource newsletter reported on pharmaceuticals in the water supply, with particular emphasis on the ramification for the West, in July 2000.4 This article has been followed by many more commenting on the phenomena of things in our H2O in addition to hydrogen and oxygen molecules.5,6 Featured Article Reprint NDA Journal 6 The concern is all these additional additives in our water can have significant effects. As tempting as it might be to now pour lithium into the water supply to achieve what is generally seen as a public health benefit, we as health professionals need to keep an objective professional and ethical eye on things. As dentists, we can’t be concerned only about the teeth. To many of the lay public, fluoride is just another government mandated drug—safe and dentally effective though it appears to be. Dentists promoting fluoridation need to be sensitive to the concerns of our fellow citizens (patient autonomy). Many in Clark County were very agitated when fluoride was placed into the storage tanks in March 2000 after voters had been told that would only happen after a public vote. However, the Water District unilaterally decided the legislature actually meant the voters could vote the fluoride back out of the water.7 No one at the water district in Washoe County has turned on the fluoride yet. Nearly everyone understands the fact that fluoride helps prevent caries. It is the ancillary issues—real or imagined— associated with fluoridation that dentists are called on to explain logically. This risk benefit analysis not only includes the concerns about adverse effects of fluoridation, but also the political freedom and self-determination of others, which may even be more important. If artificial fluoride in the water is good, why isn’t lithium, or something else? Dental professionals must be prepared to discuss fluoridation in public fora with the same expertise and sensitivity they use in their offices in face-to-face communication. 0 Editor’s Note: This article was originally published in the NDAJ Winter 2012–2013 issue. References 1. Associated Press, Wichita Advocates to Fight Fluoride Nationally, 12 November 2012, http://kansaspublicradio.org/ news/5316-wichita-advocates-to-fight-fluoride-nationally, accessed 19 November 2012. 2. Kapusta ND, Moosaheb N, Etzersdorfer E, et al, “Lithium in drinking water and suicide mortality,” Brit J Psych, 198: 346-350, May 2011. 3. Leone, CW, “Anesthetic management of lithium-treated patients,” Anesth Prog, 31:138-140, May/June 1984 4. University of Arizona, Arizona Water Resource, Pharmaceuticals in our water supplies, July 2000. 5. www.msnbc.msn.com/id/23503485/ns/health-health_care/t/pharmaceuticals-lurking- us-drinking-water/, accessed 03 August 2012. 6.www.nytimes.com/2007/04/03/science/earth/03water.html, accessed 03 August 2012. 7.Weissenstein M, “Fluoride enters Las Vegas water supply,” Las Vegas Review Journal,02 March 2000. » “…we as health professionals need to keep an objective professional and ethical eye on things.”
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