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Hello! Rain-Game is new here and likes to pixel. It has lots of fantastic ideas for pixel art but they always turn out wrong, so it focuses on the smaller projects first.

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Multiplayer survival-crafting games lack a succinct acronym or single genre-defining style, but they’re absolutely taking over the world of modern online gaming. Older MMORPG behemoths like World of Warcraft have begun a steady decline while there doesn’t appear to be any stopping the new juggernauts like ARK: Survival Evolved. These new breeds of shared sandbox worlds evolved from Minecraft and traditional MMORPGs that had dominated the last decade and a half of online gaming.

MMORPGS: The Rise and Fall

The modern video game industry grew up alongside the rise of the internet, from dial-up modems tying up phone lines to being able to stream games online and store your entire life in the cloud. Massively Multiplayer Role-Playing Games began cropping up as early as text adventures and crude pixelated games in the early 90s – most with exorbitant subscription fees that caused many a parent to faint when they saw their phone bill.

In the late 90s gaming began testing the waters of truly massive online servers with thousands of users. Emerging 3D technology helped shape new virtual worlds that players could only dream of a few short years prior. Ultima Online, EverQuest, and Asheron’s Call paved the way for even larger worlds and universes like Dark Age of Camelot, EVE Online, and Star Wars Galaxies.

The year 2004 alone saw three incredibly huge, genre-defining MMORPG releases: City of Heroes, EverQuest II, and World of Warcraft. You don’t need to be a gamer to recognize one of those games as the most popular MMORPG of all time, reaching over 10 million subscribers in 2014.

World of Warcraft wasn’t the first MMORPG but it is the last survivor of the traditional subscription-based model. WoW exploded the MMORPG market in a genre that was already seeing massive growth.

Major publishers began scrambling to concoct their own WoW. In the last decade we had the Matrix Online, Guild Wars 1 and 2, The Lord of the Rings Online, Age of Conan, Champions Online, Neverwinter, and Star Wars: The Old Republic. Even traditionally single-player franchises like Final Fantasy and The Elder Scrolls embraced MMORPG spin-off entries.

The MMORPG bubble began bursting nearly as quickly as it started. While everyone can have a different definition of what constitutes success and failure in the MMORPG world, the goal of all of these games was to produce ongoing gaming experiences that would last for years. Nearly every single monthly subscription model failed in the long run, with the 13-year old World of Warcraft being a notable exception.

Save for the occasional oddity, it’s unheard of for a MMORPG to launch with a subscription model these days. Nearly every MMORPG has had to completely shift their revenue model from subscription into either free-to-play with microtransactions or simply relying on an upfront box cost plus paid DLC. The Elder Scrolls Online represents the rare success story of the latter, shifting to a “buy-to-play” model one year after its release, and releasing its first major paid expansion earlier this year.

Your World, Crafted

But the traditional WoW-style MMORPG has become quaint when faced with the explosive new genre of Survival-Crafting games.

Minecraft changed everything. It birthed an entirely new genre based on gathering resources, shaping the world around you, and sharing it with others. And it didn’t require a monthly subscription.

This new genre of games has steadily risen in popularity over the last several years. Minecraft begat single-player survival adventures like The Long Dark, Stranded Deep, and Subnautica, 2D pixelated adventures like Terraria and Starbound, and online first-person worlds like Rust, Osiris: New Dawn, and ARK: Survival Evolved.

They take full advantage of a generation who’s grown up with high-speed internet, YouTube, and livestreaming. These games provide tense, unpredictable gameplay with heartbreaking losses and hard-fought victories, all in real-time.

This week alone sees the Early Access launch of two more online survival-crafting games – Dark and Light and Citadel: Forged with Fire. Both games could trace their genus back to ARK: Survival Evolved, which debuted on Steam Early Access in 2015 and is launching in a few weeks on August 8. These games effectively blur the line between the Massively Multiplayer Online games that were all the rage a decade ago and the new world order of Minecraft-like shared worlds and private servers.

Theme Park vs Sandbox

Most MMORPGs subsisted on the Theme Park concept. The world was set up like one grand amusement park, with everyone standing around ready to dole out quests to park-goers. It was fun to explore the park and ride the rides, but at some point you could see everything. Your mark upon the world typically ended with customizing your own character with bigger and better stuff. Regular expansions added new theme park zones to explore, but in the end it was your guild or friends that kept you coming back, not the rides or gear.

Many Survival-Crafting games generate a completely random, empty world. Your world. You, along with friends and/or random strangers (depending on the server), help create the world around you. There may be existing cities and NPCs in place, or a meticulously crafted island. But you construct the houses, tame the beasts, and assault player-built fortresses. It’s a sandbox waiting to be built.

survival-craftingTheir worlds aren’t quite as massive, instead relying on relatively smaller areas for more densely packed content and crowded neighbors who incite conflict. Servers are more democratized, with the best games offering both hardcore PvP options and more friendly cooperative atmospheres. The downside of free-form servers is they open up to hacking and cheating problems, which feels like an accepted trait that comes with the territory these games provide.

As a parent it can be difficult to navigate the murky world of online gaming. Due to the nature of building and sharing in these survival-crafting games, there’s an even greater risk of frustration, loss, and all manner of negativity, regardless of the game’s rating. Thankfully with so many games to choose from, it’s possible to steer your younger children in a direction you deem more appropriate, such as Dragon Quest Builders instead of Rust.

You can discuss with your children about what games they’re playing and why they’re playing them. Building a world together with friends can be an incredibly nurturing, positive experience at a time when many kids and teens feel they may lack control over their lives, or simply want to hang out with friends.

Only time will tell if this is the 2004 of Survival-Crafting games. We’ve seen some explosive growth in the last few years. According to Steam’s player counts, some of the more popular games in the genre like Rust and ARK: Survival Evolved hit 40-50,000 players every day, and both are still in Early Access. Meanwhile Final Fantasy XIV and The Elder Scrolls Online – hugely recognizable gaming franchises, enjoy a much more humble 10-15,000 players.

Since they don’t rely on monthly subscriptions the market may be much kinder than the MMORPGs of yesteryear. But one thing all these games have in common is they demand a large amount of time and dedication. You start with nothing and have to work hard to do everything, building your own theme park before you can ride any rides. It can be incredibly rewarding, as well as overwhelmingly frustrating.

Either way most gamers can only dedicate their time to one of these games at a time. It’s exciting to have so many new avenues to explore within a still relatively new genre. But history tells us it’s also a bubble preparing to burst, and only the best games will survive.

This article was written by

Eric has been writing for over five years with bylines in Dicebreaker, Pixelkin, Polygon, PC Gamer and Tabletop Gaming magazine, covering movies, TV shows, video games, tabletop games and tech. He reviews and live streams D&D adventures every week on YouTube. He also makes a mean tuna quesadilla.

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Mom And Son Red Car Trolly
  • On Dec 9, 2015
    Arlene from OH Asked Note: This answer was provided prior to the change to planDisney and may still contain references to Disney Parks Moms Panel.

    Is a child that is 2 years old limited to what they can ride or do at the parks?

    Hello Arlene!

    Thanks so much for stopping by the Disney Parks Moms Panel! I hope you are having a magical week! I was so pleasantly surprised at how many great attractions were available for younger kids. When my youngest was 3 we had the best time! Here are a few of the attractions we visited:

    At Disneyland Park, the iconic Sleeping Beauty’s Castle (which is breathtaking!) leads you right into Fantasyland where you can ride the infamous Dumbo the Flying Elephant and the Mad Hatter Teacups. After that, head over to Mickey’s Toontown where you can meet Mickey and Minnie, go on Roger Rabbit’s Car Toon Spin and play in Goofy’s playhouse!

    If you will be visiting Disney’s California Adventure Park The Little Mermaid ~ Ariel's Undersea Adventure is definitely a family favorite, even for my older boys. It’s a calm, slow ride with music and scenes from the movie. You can also go on Toy Story Midway Mania and see Buzz and Woody and the gang while playing a fun game. It’s Tough to be a Bug! Is great area for little ones with a splash pad, Heimlich’s train and more.

    There is so much for younger kids to see and do at Disneyland! Please let me know if you have any other questions as you plan your trip!

    See you real soon!
    - Emily
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Meet the Panelist: Emily, Colorado

I’m a wife and mom to three boys, ages 15, 10 and 6. My youngest is autistic so I love helping other special needs families plan Disney vacations and show them that they, too, can have a magical time together. In addition to being a total Disney fanatic, I am also a blogger who enjoys fashion, shopping and knitting. Learn More About Emily

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Mom And Son Spaceship Earth
  • On May 12, 2010
    Mary from NJ Asked Note: This answer was provided prior to the change to planDisney and may still contain references to Disney Parks Moms Panel.

    We are coming in June with my 2 year old and mom, and mom-in-law. We booked a reservation for dinner at Garden Grove at the Disney Swan hotel. Any suggestions on the best way to get their from PopCentury?

    I would suggest taking a bus from Pop Century over to Disney's Hollywood Studios and then hoping on one of their boats to the Swan & Dolphin hotels.  You can actually walk from Disney Studios over to the Swan, but it's a good 15-minute walk and may be a bit much in the heat in June on a 2-year-old.

    Wishing y'all a magical vacation!
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Meet the Panelist: Whitney, Mississippi

My family of 6 appreciates Disney's value! Although Ft. Wilderness is our second home, we've enjoyed the resorts for business, reunions and romantic getaways. For me, Disney also means dining: last count, I'd eaten at 55 restaurants around the World! Learn More About Whitney

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Does Transit Yield its Promised Economic Benefits? A 1969 Perspective.

June 25th, 2015

The actual economic benefits of Metro far exceed what planners estimated in 1969, and it’s worth remembering as we consider future transit investments.

In the late 1960s, when Metrorail was nearly about to begin construction, Metro published a forecast of the economic benefits of Metrorail.  The report made rosy projections of the all the travel time and costs the network, then a 97-mile proposed rail system, would bring.  (It also included photos of the pretty awesome 3-D model of a station, including maybe a one-car train?).  Now, four decades later, were the projections right?  Has Metrorail produced the benefits we thought?  The answer is yes, and then some.

Cover of a 1969 report estimating the economic benefits of Metrorail

At the time this report came out, the region was about to make a substantial investment in public transit , probably not unlike today, where we face real choices about whether to invest in Metro 2025 initiatives such as 8-car trains, the Purple Line, or bus lanes.  To quote the report,

Metro is ready for construction. The routes have been selected. The program for local financing has been approved.

How feasible is Metro? Who will benefit?  Will the benefits justify the costs? Is Metro a good public investment for the National Capital Region and its financial partner, the federal government?

The report tallied up all the time savings to riders – former motorists, former bus riders, and truckers – as well as the travel cost savings like avoided parking, vehicle savings, operating cost savings, and more.  It concluded that Metro would save $186 million per year in 1990$, roughly equivalent to $310 million/year in today’s dollars after adjusting for inflation.

The economic benefits of Metro today exceed what was forecast in 1969.

Did this turn out to be correct? Our 2011 Making the Case for Metro study posed a very similar question, and estimated the same economic benefits of Metro (travel time, costs) in 2011 at just over $1 billion/year – about three times higher than the estimate from the 60s.  There are some apples-to-oranges going on here, most notably that the 1969 study quantified the benefits of Metrorail alone, whereas the 2011 study included Metrobus. And Metrorail in 2011 was a bit bigger than 97 miles. But nevertheless, the current benefits still outweigh the 1969 study.  Interestingly, the study also predicted that the cost of Metrorail would be just under $1 billion (in 1969 dollars) – significantly less than the actual construction costs, but the difference in costs is roughly similar to the difference in benefits.

In 1969, “30% of downtown-destined commuters travel by public transportation. This is unique for a city without rail transit.”  Today, with Metrorail, that share is up to 51% according to COG/TPB Cordon Counts (PDF), even as the city has grown significantly.

Forty years ago, this region was considering a massive investment in transit, and the actual benefits have exceeded the forecasts at the time.  As we consider the costs and benefits of further transit investments, it is important to keep this in mind.

Pages from the 1969 report (click for larger)

Pages (click for larger)

Pages from the 1969 report (click for larger)

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  1. October 2nd, 2015 at 08:17 | #1

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Reading Time: 2 minutes A change of diet meant Bausch achieved Olympic success
Reading Time: 2 minutes

“They wrote me off…”

In 2012, Dotsie Bausch became the oldest Olympic Medalist in her discipline winning silver in the London Olympics just five months shy of her 40th birthday.

According to the athlete, who shared her story at the Plant Fit Summit, just a couple of years earlier her coaches hadn’t known what her role could be in cycling.

Bausch said: “They wrote me off… they said she’s marginally talented, she’s old and definitely not Olympic caliber. All those nos kept coming to me all day and almost every day…”

Instead of taking this as an excuse to give up, she developed a strong resilience. And then she turned plant-based…

Olympic success – powered by plants

“When I decided to switch to a plant-based diet, I wasn’t sure if I was going to be able to produce enough power at the start gate but boy was I wrong. Everything changed for the better and pretty much all my teammates were like ‘what is going on with you you?’

“Just plants I said. I was just as dumbfounded as they were.”

Can you imagine, a cyclist that’s been written off as to old. An athlete that is 20 years senior to her competitors. And in a sport that is plagued with doping, her team mates wonder what she is on after discovering a plant-based diet…

“I will always be 100 percent convinced that that’s why I was able to stand on the Olympic podium at five months shy on my 40th birthday.”

But not everyone is so lucky…

Most people spend the last 20 years of their lives falling sick, suffering from horrifying diseases and just getting by.

The evidence, that a plant-based diet can improve your health and fitness far beyond that of meat-eating peers, is starting to mount up.

Dr T. Colin Campbell for example has been at the forefront of nutritional research for over 40 years. At 83 years young, he is still a prominent voice in the plant-based movement.

He says: “There is no alternative way of approaching this problem…I hate to see people die early who didn’t know this information. I will continue talking about this until my last days.”

Learning from these trailblazers

Besides Dotsie Bausch and Dr. Campbell, there are so many inspiring stories that prove time and time again, that age is just a number.

When we look at the healthiest and longest living populations out there, get to know inspiring individuals like Annette Larkins, 75 years young and Mimi Kirk, 78 years young, there is one common factor.

A whole foods plant-based diet.

Ask Janette Murray-Wakelin who completed 366 marathons in 366 days in her 60s, or Ellen Jaffe Jones who has ran and placed in hundreds of races in her 60s as well.

It’s time to ditch ‘miracle pills’ invented by marketing companies and focus on what’s been proven to work.

If you’re wondering how inspirations like Janette, Ellen, Dr. Campbell or Dotsie approach nutrition for a fit, healthy and fun life regardless of your age, then join the Plant Fit Summit.

As a plant based news reader you can watch all 40 presentations this weekend for free (September 15-17). Please note: this is the final time these presentations will be available so join us here.

Vegan Bodybuilder Shares His Daily Diet Plan

Can 40 Top Doctors, Physicians, and Athletes Transform Your Body And Health?

Vegan Athletes Smash It At Fitness Contest in Texas


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You are here: Platypus /Archive for category Sophia Freeman

Discussion on the crisis of neoliberalism and the state of the Left in the EU, held April 7, 2017 as part of the 9th annual Platypus international conference.

Thodoris Velissaris
Glauk Tahiri
Lukas Hedderich
Efraim Carlebach
Pádraig Maguire
Rory Hannigan
Evan Odell
Sophia Freeman

A united and peaceful Europe seemed to be a distant dream for a generation which went through the experience of war and destruction. Today, this hope gained shape in the new realities of the European Union. Despite its official proclamation of peace, social well-being and an “alternative to capitalism and communism” the project finds itself in a prolonged crisis with uncertain expectations. The Euro-crisis, massive austerity and the increasing interference into democratic principles, a growing division between powerful and weak economies, Germany's new hegemony and the growing influence of financial capital appear in stark contrast to the official slogans of “European values and solidarity”.

The desperate struggle of SYRIZA demonstrated the necessity and seeming impossibility of the Left across Europe to answer with a politics that would be truly international and go beyond “resisting austerity.” Despite growing social unrest, the deep ambivalence towards the EU expresses itself in the inability of the Left to formulate a coherent vision of a political alternative. At the same time, the rejection of the EU is ceded to a growing Right. What is the EU for the Left today? Does the Left believe the EU should be overcome on the basis of the EU itself, or against the EU? The clarification of its nature and appropriate responses seem to be one of the most pressing issues for the Left on the continent and beyond.


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Les Paris RMC

Manage series 1756864
By RMC. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.
Tous les jours, les conseils et pronostics de la Dream Team

4548 episodes


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PlayIt4ward-Furman University

Pavelko934's Blog – March 2019 Archive (4)

Superfoods For Younger Skin Anti Aging

GoChi juice is a glass or two developed from Freelife Company. It is an improvement to their first Goji berry product Himalayan Goji Juice. Conducted is stated to be 30% less assailable than Himalayan Goji Juice.

You allow the 2003 Pirramimma age in the bottle till 2008 however it is a good blend to share now with guests. The spicy flavor would effectively with spicy Spanish foods or beef dishes.

We all know how important exercise usually the body,…

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How To Be Able To A Bmi Weight Loss Calculator

The great tea can be traced back more than 4000 years to Yunnan, today a Chinese province. For many years it was adopted exclusively for medicinal purposes, and not for enjoying. It wasn't until the Tang dynasty (618-906) that it became talked about. China has got more it sorts than I might mention in this particular article, but i shall limit myself to writing mainly about green-tea.

Do not use warm water to wash your face as it would aggravate lots of damage to your skin. Exfoliate…

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Inner Thigh Exercises For Getting Rid Of Flab

Looking for just a simple exercise to burn belly extra. Who does not? 99% of us in reality care to your spare tire and have to suck inside the belly, like diving into the shallow pool and walk quickly hoping that it seeks the path. The remaining 1%, with his six pack stomach and condescending beam. How can they get the bad and the ugly?

When in reality, frequently it's actually not good male enhancement product. Proper way know you will be getting greatest and most fun? That you are…

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Core Strength Exercises - What Is Within It In Which You?

Is summer right during the corner, or are you trying to impress somebody? Generally, people who want to lose belly fat are liable to look for ways to do it awesome. Unfortunately, there will not be fast method when planning the natural route.

You have finally made the switch from thinking that eventually things will ought to be dealt with, to knowing it's period for get and remain on the surface of your stomach. For women, there is the issue of menopause-which affects today comes…

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Wednesday night Overwatch League

Overwatch League Every wednesday Night Compete in a weekly league for monthly prizes

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Game Details

Rated: Teen
Released: May 23rd, 2016
Game Description: Clash on the battlefields of tomorrow and choose your hero from a diverse cast of soldiers, scientists, adventurers, and oddities. Bend time, defy physics, and unleash a dizzying array of extraordinary powers and weapons. Engage your enemies in iconic locations from around the globe in the ultimate team-based shooter. Take your place in Overwatch...the world needs heroes.


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Girls carrying condoms - Play Safe
The fun stuff
NSW Government
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Have you ever been in the situation where you are getting hot with a guy and then he drops the line “I can’t find a condom” while fumbling around in his bedside table or wallet? Yep, that’s a mood killer!

Girls can carry condoms to make sure they are ALWAYS prepared!

More and more girls are taking charge of their sex life because…

  • Carrying condoms = taking care of YOUR body, YOUR sexual health and YOUR future! It means that you are always in control
  • Contraception and protecting yourself and your partner against STIs is a shared responsibility – it shows that you not only care about yourself, but you care about the person you are having sex with
  • Carrying condoms means that you can always be confident and not have to rely on someone else to have a condom on them when you are about to get lucky
  • You are empowering your friends by showing them that it is OK to carry condoms and reminding them that no one judges them for doing so – in fact, it just makes them more chill being able to talk about sex and using condoms!

We all want, and deserve, safe and enjoyable sex! Carrying condoms shouldn’t be the responsibility of one gender or partner.

So slip a couple of condoms in your purse and carry them around with confidence. After all, carrying condoms puts you on top and in control!

If you want to know more you can ring the NSW Sexual Health Infolink on 1800 451 624 between 9:00am and 5:30pm Monday to Friday to talk with a sexual health nurse. It’s confidential and free if you call from a landline.

Play Safe!

Nurse Nettie

Could I have an STI?


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    Commercial Plumbing Services

    The Types of The Plumbing Problem

    There are various types of problems that can occur. The most common are given below:

    Toilet Repair Melbourne

    The leakage can occur in any portion of the system. The size can be from small to large, all

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text:
Pluralistic: 15 Mar 2020

Today's links

  1. HRDAG analyzes the best covid-19 studies: Ninja statisticians FTW.
  2. Chelsea Manning's supporters pay off her $256,000 fine in a day: She had our back so we have hers.
  3. The Onion is there for us: Doing for pandemic what they did for 9/11.
  4. The CIA's information security is really terrible: Root password was "123ABCdef".
  5. Euroleaks: exposing the secret workings of the Eurogroup: Where they decided to strangle Greece.
  6. Things to do with kids during lockdowns: A crowdsourced list.
  7. Covered Dish: A site for stories of mutual aid during a crisis.
  8. How to pull your business out of China: A guide for the anxious.
  9. This day in history: 2005, 2015, 2019
  10. Colophon: Recent publications, current writing projects, upcoming appearances, current reading

Continue reading "Pluralistic: 15 Mar 2020"


text:
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32: Pit and Fissure Sealants: Scientific and Clinical Rationale

Pit and Fissure Sealants

Scientific and Clinical Rationale

image Outline

In 2006, the Centers for Disease Control and Prevention (CDC) celebrated its 60th anniversary. What began in 1946 as a wartime agency for malaria control has become the nation’s leader in public health in regards to health promotion and prevention. The establishment and growth of such an agency represents the shift in the dogma of health care from simply curative or palliative treatment to increasing emphasis on preventive medicine. In the past several decades, “the power of prevention” perspective has been permeating health care as we have begun to focus on the burdens that chronic diseases leave in their wake—decreased life expectancy, reduced quality of life, and escalating health care costs. Of particular interest to the dental profession is dental caries, a chronic disease affecting more than 90% of adults aged 20 to 64 years.1 Although chronic diseases are among the most common and costly of all health problems, they are also among the most preventable.

Epidemiology of Pit and Fissure Caries

In the past several decades, dramatic improvements in the prevention of caries have occurred due to a multitude of factors: fluoride exposure, enhanced awareness of the benefits of early care, increased access to dental care, and increased financial coverage by insurance companies, group plans, and government-funded programs of preventive and restorative dental procedures for children.2

Despite these efforts, dental caries is still the single most common chronic disease of childhood, more common than asthma and hay fever.3 The facts from the most recent National Health and Nutrition Examination Survey (NHANES) for the years 1999-2004 are arresting1:

• By age 11 years, over 40% of children have had dental caries in their primary teeth, and over 20% have had caries in their permanent teeth.

• Data from state oral health surveys suggest that in most states, over 50% of third graders have experienced dental caries, ranging from 40% (Connecticut) to 75% (Arizona).4

• Approximately 23% of children have untreated primary tooth decay and 11% have untreated caries in the permanent dentition.

• The prevalence of dental caries in primary teeth increased significantly from 24% to 28% for 2- to 5-year-olds from the time periods of 1988-1994 to 1999-2004.

• By age 17 years, nearly 78% of children have experienced tooth decay, and by age 19 years, approximately 10% have lost at least one permanent tooth to caries.

• The progressive and cumulative effects of caries continue into adulthood, with more than 95% of adults experiencing caries and with 25% of seniors being edentulous.

Though dental caries is common, the distribution of caries is unequal, with certain subgroups of the population experiencing a disproportionately greater burden of dental disease. According to the National Institute for Dental and Craniofacial Research, 20% of the population bears at least 60% of the caries.5 Dental caries is more prevalent among children living in poverty,* with poor children experiencing five times more untreated dental caries than children in higher income families.6 Minority populations are also vulnerable, as children of Mexican-American and non-Hispanic black ethnicities are more likely to experience severe and untreated caries.7 Moreover, the pattern of caries involving specific tooth surfaces has changed. In the early 1970s, smooth surface lesions accounted for almost 25% of the decayed, missing, filled surfaces (dmfs) index. Recent data indicate that approximately 90% of caries in permanent teeth of children occur in pits and fissures, and approximately two thirds of caries are on the occlusal surface alone.8 Like permanent teeth, the pits and fissures of primary teeth are also at risk because roughly 44% of carious lesions in the primary teeth affect the occlusal surfaces of molars.8

The occlusal surface is prone to caries for several reasons. First, newly erupted, immature tooth enamel has a relatively high organic content and is more permeable, which makes it more susceptible to caries attack. Second, the pit and fissure morphology provides an environment for plaque retention and bacteria proliferation. The enamel is thinner in pits and fissures and may experience accelerated demineralization. Additionally, the molars take a relatively long time to fully erupt (1.5 to 2.5 years compared with just several months for premolars).9 This prolonged eruption time may interfere with adequate oral hygiene because toothbrush bristles have difficulty reaching the occlusal surface when it is out of the plane of occlusion, and the operculum covering the distal portion of the tooth may increase plaque retention.10 In addition, fluoride is less effective in preventing caries on the occlusal surfaces versus smooth surfaces. Data from fluoridated communities show significantly higher reductions in interproximal lesions compared with pit and fissure lesions.2 Hence, targeting preventive efforts at the occlusal surfaces of molars is appropriate for attempting to decrease the caries experience for U.S. children.

Dental caries has afflicted the human population for centuries, and before the early 1970s, treatment consisted of removing the carious tooth structure. However, in 1955, Dr. Michael Buonocore revolutionized dentistry with the first research on adhesive dentistry. From his research came the idea that dentists might have the ability to bond a physical barrier over susceptible pits and fissures and, in effect, “seal” out caries, preventing the carious process. In 1971 the first dental sealant, Nuva-Seal (L.D. Caulk Co., Milford, Del.), was introduced, and since that time many studies have examined the theory of sealing the occlusal surfaces of teeth in an effort to maximize “the power of prevention.”

Sealant Effectiveness

Unquestionably, dental sealants prevent pit and fissure caries in both primary and permanent teeth. The long-term benefit of caries reduction from using sealants on permanent teeth has been well documented as multiple studies have shown clear evidence of a reduction in caries.11-30 Recently, in an effort to meet the need for evidence-based clinical recommendations, the American Dental Association Council on Scientific Affairs convened an expert panel to address the use of pit and fissure sealants.

Beauchamp and colleagues31 provides a summary of the evidence of sealant efficacy in caries reduction:

The effectiveness of sealants in preventing caries is so well recognized in the literature that a study design with a sealant-free control group is no longer considered ethically acceptable.33 Not only have multiple independent studies concluded that sealants are effective in preventing fissure caries, three review-analyses have confirmed the caries-preventive effect.3436

Given the long clinical history and ample available literature as to their effectiveness, the expectation would be that sealants would have been widely adopted by the dental profession and utilized to their fullest preventive effect. However, even with 40 years worth of scientific knowledge, sealants are still underused.

Current Sealant Utilization

In 1974, when sealants were new technology, the initial ADA sealant utilization survey found that only 39% of dentists were placing sealants.37 Although adhesive dentistry was making great strides in acceptance for restorative procedures, using sealants for prevention was still low, and thus, by 1981 the ADA’s Council on Dental Materials, Instruments, and Equipment sponsored a major conference with the title, “Pit and Fissure Sealants: Why Their Limited Usage?” By the late 1980s and 1990s, regional and national surveys indicated large increases in sealant use among dentists.38,39 A recent survey reports that 79% of dentists use sealants in their practice “very often” or “often” in permanent teeth, whereas 53% “rarely” or “never” use sealants in primary teeth.40 Regional surveys indicate that most pediatric dentists (up to 96%) and most recent graduates (90% of dentists in practice for 10 years or less) use sealants.39,41,42 However, despite the reported increased incorporation of sealants into dentists’ practices, the number of children receiving sealants is unexpectedly low.

Data from the NHANES for the years 1999-2004 suggest that the prevalence of dental sealants on permanent teeth in children aged 6 to 11 years was 30%, and for adolescents and adults aged 12 to 29 years, it was 38%.1 Both of these figures are a significant increase from the 1988-1994 prevalence at 22% and 18%, respectively. However, in the low-income population, sealant use rates still remain low and have been found to be only 22%.43,44 Dennison and colleagues45 examined an insured population and also found a low sealant utilization rate. Even though sealant placement was a covered benefit, the researchers found a sealant use rate of 8.4% for first molars and 5.5% for second molars. With the knowledge that by age 17 years, nearly 78% of adolescents have experienced tooth decay and that 90% of these caries occurs in the pits and fissures, one might expect much higher rates of sealant use.

In 2000, the Healthy People 2010 Objectives for Improving Health was issued as a set of disease prevention and health promotion goals for the United States. Healthy People 2010 set a goal for the prevalence of sealants in children and adolescents to increase to 50%. However, oral health surveys of various states suggest that many were not able to meet this goal, with at least 30 states falling below the 50% goal.4

Low usage has been attributed to lack of confidence in the bonding of sealants to enamel, concern for sealing over caries, and to the difficulty of achieving isolation.46 Survey data indicate that dentists are apprehensive about sealing over incipient caries, because 80% of respondents indicate that they choose not to seal over incipient caries.47 Fear of placing a sealant over caries was one of the most frequently voiced concerns in the survey’s comments section. However, numerous studies have demonstrated that caries left underneath intact sealants remain arrested.4851 Sealants significantly reduce the bacteria levels in cavitated lesions because retained sealant deprives bacteria of access to nutrients; bacteria that persist under sealants cannot produce acid when isolated from carbohydrate substrate, and thus progression of the lesion is unlikely.52 Oong and associates52 found that sealing over noncavitated lesions reduced the probability of lesion progression by more than 70%.

Another significant reason cited for limiting sealant usage is the lack of reimbursement for sealant placement. Many surveys reveal that lack of insurance reimbursement for both initial placement and reapplication is a frequently reported reason for limiting sealant usage.39,40,47 Concerning the lack of reimbursement, insurance companies provide the following reasons53,54: (1) concerns about cost-effectiveness of sealants, (2) sealant exclusions in the original or current contract, (3) undefined guidelines for sealant placement, and (4) potential for inappropriate usage and fees. However, these reasons are not well-founded. Of the insurance companies that do provide sealant coverage, approximately two thirds define certain clinical conditions for reimbursement, such as age limitations and restriction of sealant placement to permanent teeth, with some specifying molars only.39 Medicaid programs have made significant strides in making sealants a covered benefit. In 1991 only 58% of Medicaid programs provided reimbursement, but by 1994 all 50 states included sealants in their Medicaid programs.42,55 Hopefully, all third-party payers will recognize the benefits of sealants and add them as a covered benefit.

How Sealants Work

Three types of materials are used as sealants: resin, glass ionomer, and polyacid-modified resins. The most commonly accepted material is the resin-based sealant because it has shown superior retention rates compared with glass ionomer sealants.56-59 The resin-based sealant utilizes the principles of adhesive dentistry because given that it is retained by micromechanical retention. For the adhesion of the sealant to the enamel to be successful, the tooth must be clean and remain dry because the resin is hydrophobic. The tooth enamel is etched with 35% to 37% phosphoric acid, which creates surface irregularities that the sealant material flows into and forms resin tags (Figure 32-1). The resin is polymerized (usually by visible light, but there are also autopolymerizing resins) and forms a thin, plastic coating over the pits and fissures of the occlusal surface. This physical barrier is the essential component in preventing the carious process (Figure 32-2).

Glass ionomer sealants have a different bonding mechanism. They adhere to the enamel through retention, chemcial bonding, and chelation. However, the chemical bond alone is weak. Glass ionomers are hydrophilic and can withstand some minimal moisture. For the glass ionomer sealant, the tooth is cleaned, and a tooth conditioner of polyacrylic acid is applied. The tooth is rinsed and dried, and the glass ionomer is placed on the occlusal surface. If it is a resin-modified glass ionomer, it is light cured.

Types of Sealants

Sealant products come in a variety of materials, colors, and viscosities. Resin-based sealants are available as unfilled, filled, clear, colored, visible light–polymerized, autopolymerizing (chemically cured), and fluoride-releasing materials. The earliest sealants were autopolymerizing, but these have largely been replaced by visible light–curing sealants. The benefits of light-cured versus chemical-cured sealants are the following2: (1) the sealant material sets in 10 to 20 seconds versus 1 to 2 minutes; (2) no mixing of resins is required, eliminating the incorporation of air bubbles; (3) the viscosity of the sealant remains constant during infiltration of etched enamel pores; and (4) the sealant material does not set until it is light activated. However, studies have shown similar retention rates and similar strengths.33,6062

Sealants are often available as clear or opaque white. The advantages to an opaque sealant are that it is easy to see during application and easy to monitor its retention at a recall visit. Assessment of a clear sealant requires tactile exploration of the sealed surface. One study that examined the visibility of clear and opaque sealants found that the error rate for identifying an opaque sealant was less than 2%, whereas for clear resin it was nearly 23%. Moreover, the most common error for the examiners was to incorrectly identify a clear resin sealant on a tooth that had not been treated.63 No apparent difference in the clinical efficacy of either type of sealant has been reported. However, as will be discussed later, sealant retention is critical for the caries-preventive effect; hence, being able to quickly and correctly assess sealant retention is clinically important.

Two newer materials are available that have color properties. Clinpro (3M ESPE, St. Paul, Minn.) is a sealant that is pink upon application and turns white when cured. This color change provides no clinical advantage and has been described as a “perceived marketing benefit.”64 However, the sealant may be chosen for its other properties. Another material that provides a color change is Helioseal Clear Chroma (Ivoclar Vivadent, Amherst, N.Y.). This material is a clear sealant containing a photochromic dye that is normally light yellow. However, the dye can change from clear/yellow to green when exposed to the correct wavelengths of blue light. This color change is clinically relevant because it may assist a provider in assessing the sealant’s retention upon recall examination; however, using a polymerizing lamp to view the color change is an added step compared with assessing an opaque sealant. The color changing sealants have similar properties to and are as caries-protective as other resin-based sealants.6568

Filler Content

Sealants also are available with various filler content. For the most part the filler content dictates the sealant’s physical characteristics in regard to viscosity, flowability, and resistance to wear. The theory is that unfilled sealants will penetrate deeper into the fissures because of their low viscosity, create longer resin tags, and therefore be better retained. Although data from one study suggest that unfilled sealants are retained better,69 other studies have found similar retention rates with unfilled and filled sealants.70,71 Unfilled sealants have lower rates of microleakage68,72,73 and better penetration into the fissures.74,75 Another clear advantage of the unfilled sealant is that occlusal adjustment is not necessary. Because of the lack of filler, the unfilled sealant will abrade rapidly if left in occlusion. On the other hand, filled sealants require occlusal adjustment because individuals are not able to abrade occlusal interferences caused by filled sealants to a comfortable level.76 Simonsen suggests that the necessity to adjust the occlusion increases the time and cost of the procedure, and it may also prevent delegation of sealant placement to auxiliaries.64,77 However, despite this clinical disadvantage, several studies have examined the use of flowable composite as sealant.

Early studies examining flowable composite showed inferior retention and microleakage compared with unfilled sealants.72,78 However, other studies have found that utilizing a bonding agent before placing the flowable material improves fissure penetration and decreases microleakage.79,80 Two studies evaluating the clinical retention of flowable composite used as a sealant with bonding agent have concluded that flowable composite is equal to65 and possibly superior to conventional sealant materials.81 However, given the added expense of the need for a bonding agent and the need for occlusal adjustment, the conventional unfilled resin-based sealant appears to be the most appropriate preventive therapy.

Fluoride-Releasing Sealants

Based on the knowledge of the benefits of fluoride release from glass ionomer materials, dental manufacturers have also developed fluoride-releasing resin sealants. However, studies have shown that salivary fluoride levels are the same before and after sealant placement, and there is no long-lasting release of fluoride to plaque and saliva.82,83 Additionally, clinical studies have not demonstrated significant caries prevention of fluoride-releasing sealants over those benefits obtained from conventional sealants.84 The addition of fluoride to resin sealants seems to be more of a marketing benefit by manufacturers because a clinical benefit appears doubtful.64 Several studies have shown similar retention rates of fluoride-releasing sealants to those of conventional sealants.84,85 However, in a systematic review of 31 studies (9 of which corresponded to fluoride-releasing sealants), Muller-Bolla and colleagues61 found that fluoride-containing sealants have lower retention rates at 48 months or more. Furthermore, they conclude that it is erroneous to consider fluoride-containing sealants as a fluoride reservoir with long-term release of fluoride into the immediate environment.

Therefore it appears that the most logical choice for a resin-based sealant is a conventional, unfilled sealant that is opaque and has a convenient delivery system.

Glass Ionomer

Glass ionomer cement sealants were introduced as an alternative to resin-based sealants because of their fluoride-releasing and recharging ability, higher moisture toleration, and easy application. It is generally accepted that the effectiveness of sealants depends on long-term retention,34 and in clinical studies, retention is considered the principal evaluation criterion because it is used as a surrogate measure of effectiveness in preventing caries.61 When compared with resin-based sealants, glass ionomer sealants have shown poor retention rates.24,34,58,86 The evidence-based recommendations endorse the use of resin-based sealants because there is limited and conflicting evidence that glass ionomer cement reduces caries incidence in permanent teeth of children.31 However, the most recent systematic review with meta-analysis found no evidence that either material was superior to the other in the prevention of dental caries.87 This review summarizes studies that show that while glass ionomer sealants are not retained as well, the caries-preventive effect is similar to resin-based sealants. Two other reviews have reached similar conclusions.12,88 The theory for the protective benefit is that glass ionomer material remains in the deepest parts of the fissures even though it is not clinically evident.89 Seppa and Forss90 suggested that fissures sealed with glass ionomer are more resistant to demineralization, even after the sealant visibly appears to have debonded. This may be a result of the combined effect of the fluoride release, which increases the microhardness of the enamel, and of the residual material in the bottom of the fissure.

Glass ionomer sealants are widely used in countries with limited access to dentistry as part of the atraumatic restorative treatment (ART) technique. (See Chapter 21 for a discussion of ART.) A recent meta-analysis concluded that the survival rate of ART sealants after 3 years was 72%, whereas the caries-preventive effect was 97%.91 Furthermore, this review indicated that high-viscosity glass ionomers are the correct glass ionomer for ART sealants, because high-viscosity sealants placed with “finger pressure” penetrate as well as resin sealants, and high-viscosity materials are better retained than those of low to medium viscosity.

Nevertheless, current recommendations from the American Dental Association Council on Scientific Affairs, recommend resin-based sealants as the first choice for dental sealants. They also suggest that glass ionomer sealants may be used as an interim preventive agent when there are indications to place a sealant but moisture control may compromise sealant placement.31

Polyacid-Modified Resin Composites (Compomers)

Polyacid-modified resin composites were introduced in the 1990s as a new class of materials designed to combine the aesthetic property of composite with the fluoride-releasing property and adhesion of glass ionomer. These materials have been nicknamed compomers. They are similar to composites in that they contain no water and are hydrophobic, set by a polymerization reaction, lack the ability to bond to tooth structure, and require bonding agents of the type used with conventional composite resins.92 Like glass ionomers, they do release fluoride; however, their fluoride release levels are significantly lower than those of glass inomer cements.92

As a sealant material, polyacid-modified resin composites underperform glass ionomer cements in terms of fluoride release and underperform conventional resin composite materials in terms of retention. Polyacid-modified resin composites show low retention rates of 5% after 48 months and 3.4% after 6 years.93,94 Mechanical preparation of the tooth increases the retention rate of these materials; however, the marginal integrity is poor, and there is considerable occlusal wear.95,96 In a review of the effects of the advances in adhesive materials on sealant protocol, Boksman97 concludes that “current research cannot support the use of polyacid-modified resin composites for use as pit and fissure sealants.”

Who Really Needs Sealants?

Caries Risk Assessment

Caries management emphasizes the need for caries risk assessment, which is the likelihood of the incidence of caries during a certain time period. It is important to analyze the risk of caries for an individual during the decision-making process for sealants. Placing fissure sealants should not be considered routine for all children, because teeth with a low risk of developing caries receive little benefit from sealant placement,20,98 and it is not cost-effective.99,100 Patients should be evaluated for overall caries risk, but individual teeth should be evaluated as well. Heller and colleagues98 studied caries progression in sound teeth with and without sealants and in teeth with incipient carious lesions (defined by dark staining of the grooves, chalky appearance, or a slight explorer catch) (Figure 32-3) with and without sealants. These researchers found that the preventive benefit for sealing sound teeth was only 4.5%, whereas sealing over incipient caries lowered the caries incidence by 41%, almost a tenfold difference. Therefore sealants are indicated when the dentist determines that the tooth or the patient is at risk of experiencing caries.31

Age at Placement

Previous studies from the 1950s and 1960s showed a peak in caries incidence occurring shortly after tooth eruption and then tapering. The theory was that the occlusal surface was most vulnerable to caries within the first few years after eruption and that the risk of developing caries after this time period dropped dramatically. However, longitudinal data from the post-fluoridation era show new carious lesions develop yearly.101,102 In 1988 Ripa and associates101 analyzed data from nearly 2000 children aged 10 to 13 years who were examined annually for 3 years to determine caries activity. The authors found that the occlusal surfaces of molars suffered relatively constant attack between ages 10 and 16 years, at a rate of 10.4% per year.101 New information indicates that fluorides may have caused a delay in pit and fissure caries resulting in occlusal surfaces that decay at a later age.103 Hence, the nature of primary caries is changing from a rapidly progressing disease of childhood to a slowly progressing disease that commences in childhood but progresses steadily in adulthood.103 In accordance, the evidence-based recommendations endorse that adults as well as children should receive sealants when the tooth or the patient is at risk of experiencing caries.31 The question of whether to place a sealant over a fissured surface should not be based on how long ago the tooth erupted but on the clinical impression of whether a sealant is necessary to prevent caries.2 Figure 32-4 is a decision-making tree for sealant placement and can be used to help dentists decide when to apply sealants.

Which Teeth Should Be Sealed?

Traditionally, noncarious first and second permanent molars with deep fissures were the candidates for sealants; however, recommendations have been extended to any tooth at risk of developing caries, including primary teeth, permanent molars with incipient, noncavitated lesions, and/or premolars.31 At-risk primary teeth benefit from sealant placement because resin-based sealants are retained well on primary molars, with retention rates in the 70% to 95% range at approximately 3 years.104,105 Glass ionomer cements are not retained well and are not recommended for use as sealant material on primary teeth.106 Given the preventive benefit to the primary molar, when the child is able to cooperate for sealant placement, sealants should be used.31

The indications for sealant placement include2: (1) deep, retentive pits and fissures, which may cause wedging or catching of an explorer (Figure 32-5); (2) stained pits and fissures with minimal appearance of decalcification or opacification (i.e., incipient caries with no cavitation) (see Figure 32-3); (3) no radiographic or clinical evidence of interproximal caries in need of restoration on teeth to be sealed; (4) use of other preventive treatment, such as fluoride therapy, to inhibit interproximal caries formation; and (5) the possibility of adequate isolation from salivary contamination. Therefore, if placing a sealant is clinically indicated on any tooth with pits and fissures, a sealant should be used to prevent caries development.

Contraindications for sealant placement include2: (1) well-coalesced, self-cleaning pits and fissures; (2) radiographic or clinical evidence of interproximal caries in need of restoration; (3) presence of many interproximal lesions or restorations with no preventive plan/treatment to inhibit caries formation; (4) life expectancy of the primary tooth is limited; and (5) no possibility of adequate isolation from salivary contamination due to either eruption status or patient behavior.

Diagnosing Occlusal Caries

Diagnosing occlusal caries can be difficult, and research has shown that dentists correctly diagnose occlusal caries in only 42% of cases.107 In 2005 Stookey108 challenged the long-held belief that probing an occlusal groove with an explorer was necessary to diagnose a carious lesion. He summarized the evidence, which suggests that the use of an explorer does not increase dentists’ ability to make a correct diagnosis, and forceful use of an explorer can actually damage the tooth. Dentists are just as likely to make a correct diagnosis of a dry tooth in terms of the presence or absence of caries using only visual inspection as they are when they use an explorer.107 Proponents of eliminating the use of an explorer raise the concern that not only is tactile examination unreliable, but that forceful explorer usage can cause enamel defects, resulting in possible caries development or progression by causing cavitation of a previously noncavitated lesion.109 In one study, dentists were asked to gently probe a sample of third molars, half of which had initial carious lesions and half of which had sound occlusal surfaces.109 The teeth were then extracted and the fissures were examined with a scanning electron microscope, and enamel defects were noted for all of the teeth with initial caries and for two of the sound surfaces. The authors conclude that probing the occlusal surface with an explorer should be replaced by meticulous visual inspection. Opponents of the explorer do not endorse eliminating its use altogether. They recommend that the explorer be used differently, mainly to eliminate plaque in the fissures and to determine surface roughness of incipient lesions108: “The tip of the explorer should be moved gently across the surface of any noncavitated area to determine the presence or absence of surface roughness as an indication of whether the underlying demineralized area reflects an active lesion.”

Advocates of the explorer point to its historical use and emphasize that it is a time-tested tool for caries detection.110 Tactile diagnosis is taught universally in dental schools, and there are specific criteria for the detection and diagnosis of pit and fissure lesions.

Caries is present when the explorer catches or resists removal after the insertion into a pit or fissure with moderate to firm pressure, and when this is accompanied by one or more of the following111:

A simple catch of the explorer is not enough to diagnose a carious lesion because the tip of an explorer may exhibit “tugback” if the tip of the explorer corresponds well to the size of the pit.

Though there are proponents on both sides of the argument, the evidence-based recommendations published in 2008 state that “the use of explorers is not necessary for the detection of early lesions,” because the use of an explorer does not improve the validity of the diagnosis of fissure caries compared with that of visual inspection alone.31,107 Visual examination alone (of a clean, dry tooth) is sufficient to detect early lesions. Moreover, forceful use of an explorer in demineralized fissures can, in essence, cause cavitation by creating an entrance through which cariogenic microorganisms can penetrate into the softened substructure.112

Given the challenge of occlusal caries diagnosis, adjuncts can be helpful. Several new technologies have shown promise in recent literature: light-induced and infrared laser fluorescence devices (Figure 32-6, A), a device which measures changes in heat and luminescence (see Figure 32-6, B), the electronic caries detector, quantitative laser fluorescence, and transillumination.2 However, to date, no technology can substitute for a thorough visual exam and clinical judgment based on experience.

Sealing Over Incipient Caries

If sealants are applied properly and are monitored periodically, caries arrest beneath a sealant. First, sealant application significantly decreases the viable bacteria in pits and fissures. Acid etching alone eliminates 75% of the viable microorganisms.113 In a recent review of six studies that addressed the reduction in viable bacteria after sealant placement, the authors found that sealing caries was associated with a 100-fold reduction in mean total viable bacteria counts.52 Secondly, studies show that sealant placement greatly reduces the number of carious lesions that progress. In a recent meta-analysis that examined the effectiveness of sealants in preventing progression of carious lesions, Griffin and colleagues48 found that the mean annual percentage of noncavitated lesions that had been sealed and still progressed was only 2.6% versus 12.6% of unsealed early, noncavitated lesions. The authors assert that “these findings not only support the placement of sealants to manage and arrest lesions determined to be in the early carious stages, but also, just as importantly, support their placement for surfaces where caries is uncertain.” Mertz-Fairhurst and coworkers50 published a classic study in 1998 in which they examined the cariostatic effect of sealed restorations after 10 years. One of the treatment groups included teeth with frank, cavitated lesions in which the only preparation provided was placing a 1-mm wide bevel in sound enamel around the margin of the lesion. The carious tooth structure was not removed. The teeth were restored with the following technique: etch, prime, bond, place composite, and then place sealant over the restoration. Of the 85 teeth available for follow-up at 10 years, only 12 of these teeth had failed. Although this article does not advocate sealing over frank, dentinal caries, it does highlight the power of the coronal seal. Whenever a situation occurs in which the practitioner is certain that a restoration is not yet warranted but is unsure of whether the fissure is simply stained or is exhibiting signs of incipient caries, the practitioner should err on the side of placing a sealant rather than monitoring the lesion.

Practitioners who are concerned about sealing over caries will often decide to take an invasive approach by prepping the tooth “just in case.” Some will erroneously call this a preventive resin restoration (PRR) when, in fact, it is most likely a fissurotomy or enamelplasty procedure. The PRR is more appropriately termed the conservative adhesive resin restoration. (See Chapter 21 for a discussion of conservative adhesive restorations.) It is considered an ultraconservative preparation because only the small areas of caries are removed; intact pits and fissures are not opened with a bur. A restorative material (composite, glass ionomer, ama/>

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FreeBuds 4 review

HUAWEI managed to put itself in a really good position. As a company, it has an audio product for everyone. Prefer over-the-ear headphones? Check out the FreeBuds Studio. Want a comfortable pair of ANC buds? Check out the FreeBuds 3 (and well, the successor we’re looking at today, the FreeBuds 4). Want both passive and active noise cancelation? Look no further: FreeBuds Pro.

Of course, we only mentioned the flagship products in our enumeration above, but you’ll be happy to find out there are plenty of other products in their portfolio, like the FreeBuds 4i, and the FreeLace Pro, just to name a few, so they really have something for every taste, need, and wallet.

The FreeBuds 4 build on the success of the FreeBuds 3, with the company retaining the design principles and overall looks of the earbuds, but making slight changes and tweaks to improve upon the predecessor. We’ll be looking at those, and of course the resulting product, in our HUAWEI FreeBuds 4 review below.

FreeBuds 4 in hand

HUAWEI FreeBuds 4 specs

Compared to the FreeBuds 3, the FreeBuds 4 is slightly smaller, both comparing the buds themselves, as well as the charging case.

One earbud weighs a mere 4.1 grams, and measures 41.4 mm in height, 16,8 mm in width, and 18,5 mm in depth. The charging case weighs 38 grams (with the buds removed) and, since it’s pebble-shaped, has a diameter of 58 mm and a height of 21.2 mm.

Inside, you’ll find a slightly larger, 14.3 mm driver, and the same Kirin A1 chip that is used to power the company’s GT2-series of smartwatches, earbuds, and even the FreeBuds Studio.

FreeBuds 4 on table

Battery capacity didn’t suffer from the overall slight reduction in size, with units rated 30mAh per earbud, and 410mAh for the charging case.

Bluetooth connectivity has been upgraded to Bluetooth 5.2, and the earbuds this year have earned their IPX4 rating against splashes from all directions.

Wireless charging has been dropped, with no clear plans to offer a version that supports it in the future, and so was the bone sensor that was a feature on the predecessor.

Design, build and fit

The design, per se, is beautiful, and pretty much in line with what we’re used to getting from HUAWEI on its premium products. The finish is also top-notch, with nothing further to report.

earbuds in hand

HUAWEI went with the open-fit design, similar to the FreeBuds 3, which makes me really excited about the FreeBuds Pro’s successor this year. An open-fit design has its pros and cons. We’ll talk about them, but if you’re someone who doesn’t like in-ear canal earbuds (like the FreeBuds Pro and more recently, the FreeBuds 4i), you should definitely take a look at these.

Fit-wise, because of the open-fit design, HUAWEI had more wiggle room to optimize the size and shape of the FreeBuds 4 to comfortably fit most ears. After a couple of minutes, you forget you’re wearing them. They’re comfortable and due to their light weight, you easily get accommodated to wearing them.

Those are two of the major pros of an open-fit design. We’re going to address the cons in the segment below pertaining to audio quality and ANC. However, we’d like to preface this with the fact that they’re only cons if you’re coming from an in-ear canal design. If open-fit is your bread and butter, you should dismiss these so-called cons.

earbud in hand

Audio quality, ANC, and Experience

Audio quality

We have to approach the audio quality and ANC conversation from the open-fit design standpoint. Of course, an over-the-ear design will sound better because of the larger drivers, while also offering better noise isolation, and the in-ear canal earbuds will offer the best audio quality and ANC thanks to their passive noise cancelation and isolation of the sound inside the ear canal.

The 14.3 mm drivers inside the FreeBuds 4 offer a really pleasant sound. They’re lacking a bit on the low end of the spectrum, where the bass and lower-mids reside, but that’s just a consequence of the open-fit design. Consequently, if your taste in music involves heavy bass and punchy lows, the FreeBuds 4 might not be the earbuds for you. However, they are really silky on the mids and highs, with emphasis on vocals and instruments.

There aren’t many settings to play with inside the AI Life app in terms of audio quality, and you can even get away with using them without the app which at this point, aside from customizing controls and updating firmware, does little to nothing to improve the audio experience.

FreeBuds on table connected

Active noise cancelation

HUAWEI claims ANC has been improved over the predecessor. We’re not saying they haven’t, we’re saying that we didn’t see a discernable, significant improvement. ANC is there, and it works.

Does it block out as much noise as the FreeBuds Pro or FreeBuds 4i? Of course not, as those have the advantage of extra passive noise cancelation thanks to the in-ear canal design.

With the FreeBuds 4, noise cancelation will almost fully block out an air conditioner or a fan, but anything beyond that will bleed through due to the open-fit design.

Considering that having ANC on almost halves the battery life (from 4 hours to 2.5 hours), we’ll advise you to keep it off unless you specifically need to turn it on. And, when you do, expect, depending on the environment, for some noise to be blocked out, with most of it seeping through in a muffled, muted, or otherwise unadulterated manner.

FreeBuds 4 on Mate Xs

We’ve been using the FreeBuds 4 for phone calls, VoIP calls (Signal, Zoom, Skype, Google Meet) as well as listening to music. All of the above was delivered in line with the expectations. We covered the audio quality in the segment above, and voice calls sounded good. On the other end of the line, people said they can hear us clearly, irrespective of the call quality (lesser phone calls, upper VoIP calls).

Dual-device connectivity (the ability to be connected to two devices at the same time) will definitely come in handy if you want to bridge the gap between work and play. I do most of my work on my computer while I listen to most of my music from my phone.

With wear detection, you don’t have to fumble for the pause button when you quickly want to stop your music. Just take them out of your ears and multimedia playback will immediately stop.

Battery life is close to the one advertised. 4 hours without ANC, 2.5 hours with ANC, and 22 more hours with the charging case and no ANC. While this is similar to the numbers of the FreeBuds 3 and definitely manageable, there are other HUAWEI and competitor models that offer more. It’s just fair to mention that!

Charging will take about an hour both for the earbuds and for the charging case. Currently only wired charging is available, so don’t expect to use reverse wireless charging on your phone to keep them going while you’re out.

The stem of the buds is touch-sensitive, and, while you can configure the actions inside the AI Life app, the defaults are double-tapping for play/pause, long-tapping for toggling ANC on/off, and swiping up and down to increase/decrease the volume. Thanks to this feature you can get away with using the FreeBuds 4 without AI Life, on another Android, or even iPhone or Mac.

When you do use the AI Life app, you can update the firmware (we got one update during our review period), configure the aforementioned gestures, and try to locate the earbuds should you have misplaced them.

Last, but not least, HUAWEI seems to have made it a mission for users to struggle to remove the earbuds from the charging case. Maybe it’s just me, but I seem to struggle with every model from the company, and the FreeBuds 4 are not at all easier to remove. It’s a combination of the magnets and the shiny surface and finish that denies the proper grip for easy removal.

HUAWEI FreeBuds 4 review

The FreeBuds 4 are a perfect pair of elegant earbuds if you’re new to Wireless, ANC-enabled models. We don’t consider them a significant step-up from the FreeBuds 3 in order to advise an upgrade.

The addition of the IPX4 rating means you can wear them in the rain and even the gym, as splashes of water won’t damage the earbuds. That right there is a great selling point, in addition to silky smooth sound (lacking a bit on the low end), and its relatively small footprint.

They currently go for £129.99 in the UK and you get a HUAWEI Band 4 Pro (valued at £49.99) as a gift. You can currently buy them in the EU for €119.00, where they’re currently off (at the time of this review) from €149, but the discounts vary from region to region, so make sure to consult your local HUAWEI store for the latest prices.

one earbud in hand

Pros and Cons

+ lightweight and comfortable;
+ touch gestures;
+ silky smooth sound;
+ dual-device connectivity.

– weak ANC;
– poor battery life with ANC;
– audio lacking on the low end;
– no wireless charging.

Anton is the Editor-in-Chief of Pocketnow. As publication leader, he aims to bring Pocketnow even closer to you. His vision is mainly focused on, and oriented towards, the audience. Anton’s ambition, adopted by the entire team, is to transform Pocketnow into a reference media outlet.

Contact: [email protected]

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text: First hour featuring, with Poets @ Artfest V coming up this weekend in its 5th year in that annual series, I’ve selected 6 readings from the first two sessions of the first day of the very first festival in 2015. In this hour, you’ll hear readings by Paul Kelley, Elizabeth Greene, and John Donlan. Second hour featuring, from again the original Poets @ Artfest in 2015, you’ll hear readings by Alyssa Cooper, David Pratt, and Susan Olding.


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Mar 23rd, 2009 | By | Category: Audio Podcasting, Podcasting, Podcasting Events, The New Media Update

http://www.flickr.com/photos/danardvincente/2512148705/We have asked some of our friends and colleagues who attended technology and new media conference South By Southwest Interactive (SxSWi) to share their highlights and takeaways from the conference, which wrapped up earlier this week.

Today we share the third part (of four) by guest correspondent Susan Bratton:

Social networks & online communities

Some of the most spirited discussion in my conversations revolved around the question, “If a company wants to create a solid social networking community around their brand, what are the most important things they should know/do?

‘If You’re Not Pissing Someone Off, You Might As Well Go Home’

Patricia Martin, founder of LitLamp Communications and author of â€œRenGen,” says sheâ€™s keeping her finger on the pulse of â€œconnoisseurs of community development.â€

â€œNow consumers enter into the world as content creators rather than content consumers and how they are now seeking to actually control their identities is really interesting,â€ Patricia says. The Millennials [today’s young adults who came of age with ubiquitous computers and portable digital media] are an online reputation management-savvy generation. Patricia notes they are managing themselves as brands.

Another power tip came from Guy Kawasaki, co-founder of AllTop and author of â€œReality Check:” â€œif youâ€™re not pissing someone off on a social network, you might as well go home.â€ Guy has 85,000 followers. His point being, with so many followers, you cannot take personally any negative feedback.

Guy’s rationale: We agreed that whereas a marketer used to follow the axiom, â€œone bad customer complaint represents one hundred people who feel the same way and remain silent,â€ in todayâ€™s consumer-generated content world, one complaint is often simply that.

Courting Key Influencers In The Community

Angela Benton, Founder and Publisher, Black Web 2.0, suggests marketers find influencers for your brand by focusing on those who have smaller, but deeply connected followers. Trying to target only the very well-known in the social space can come off as shrill and could backfire on your â€œauthenticity.â€ With all the talk about paid bloggers, itâ€™s important to focus on those influencers who can rally customers for you who will resonate with your offering.

Cathy Brooks, Consultant, Other Than That, talked about helping mobile device maker Nokia place their phones into “more vertical” social communities. â€œThere are so many people in so many markets: politics, food, family, technology, all of it, so how do put these devices into the hands of people who really need to use them everyday?â€

Cathy is expanding the reach for Nokia into the second and third concentric circles of bloggers and Twitterers — people who can be brand advocates, who are influential to their own [niche] group. True, the Nokia conversation might not hit 100,000 people through a single influential person. But, if that blogger or Twitterer or podcaster has two or three hundred, or a thousand of exactly the right people that follow them, they are a key â€œradiator.â€ Those followers, subscribers, readers,Â  look to that particular person as someone who really does influence the decisions of many.

This has been Intelâ€™s marketing strategy for nearly 20 years. Educate the influencer (aka the well-regarded, outspoken PC computer geek), and they will make the rationale to their followers why a PC with â€œIntel Insideâ€ is worth a premium price.

Tara Hunt, who is Marketing Lead-Partner Platforms, at Intuit says that at Intuit, they created the platform for their small-business-owner clients to convene. For the most part, they [Intuit] stay out of the way. The community does “a darn fine job supporting each other,” Tara says.

Should brands be the facilitators of the conversation about their product?

Tara, The Advance Guard’s C.C. Chapman, Aaron Strout of Powered, Inc., and many others believe there are situations when it is appropriate for a brand to step in, to foster a community.

Henry Jenkins, Director of Comparative Media Studies, MIT, feels otherwise. He thinks you should go where your customers congregate. I asked him how to find these places, and Henry eloquently said:

â€œthe best way is to use a variety of search tools. So search Twitter, search the blogosphere, search Google, search every engine that brings you to sites where conversations are taking place. Listen to podcasts that are tied to the products that youâ€™re involved with. Read the blogs, go to Live Journal, go to, you know, all of the other social network sites. You will find activity and discussions spontaneously occurring.

“You donâ€™t need to bring people into your studio and run a focus group now. What you need to do is recognize how this product is used and talked about in the field. Engage with the people, engage with your consumers on that level. But you also are going to need to figure out whatâ€™s your value [of your input and participation]? Why should they listen to you? Whatâ€™s your point of entry into this conversation?

“So when I talk to companies, they often are saying, ‘Weâ€™re worried about losing control over our brand message.’ Well, the reality is, you lost control a long time ago. Your consumers can take your brand and do with it more or less what they want. You might stop some of them with cease and desist letters, but youâ€™re not going to stop all of them — and youâ€™d be an idiot to sue your consumers.

“But what you can do is get into the game. By getting into the game, I mean you create a value for that community. You give them something thatâ€™s a resource that allows them to talk to each other about the brands that matter to them. You give them things that they can take back with them, back to wherever the communities theyâ€™re involved with, and continue the conversation. Sometimes you can become an active part of that conversation. But sometimes, just as importantly, you merely [provide] the resources that is at the center of the conversation.â€¦â€

Guest correspondent Susan Bratton is the CEO of the Personal Life Media network. I know her through the time I spent on the board of the Association for Downloadable Media (ADM), where Susan is Vice-President of the organization. She was also instrumental in setting internet advertising standards in helping create the Internet Advertising Bureau (IAB).

Susan’s interviews will also be blogged by Aaron Strout, CMO of Powered here.

Photo: “Web 2_0” by Danard Vincente

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No Responses to “Highlights of SxSWi: Susan Bratton (part 3) Social Networks and Online Communities”

  1. Annalise says:

    Creating a community around your brand using social networks is very important in today’s marketing world. It increases brand awareness and ultimately increases revenue. Your social networking community increases conversation and creates engagement about your brand. -Annalise, ezanga.com

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June 29, 2016 – Nurse Autonomy

June 23, 2016

Anchor lead: The Veteran’s Administration is taking the lead on empowering nurses to do more, Elizabeth Tracey reports

Nurses are being empowered by the Veteran’s Administration to take on more responsibility and do as much as they are licensed to do without the oversight of doctors, according to a proposed new rule, with the intention of providing better and more timely medical care to the nation’s veterans.  Trish Davidson, dean of the Johns Hopkins School of Nursing, comments.

Davidson: I think why the VA is focusing on this is because of the chronic and complex needs of many of their patients, and it’s in that area where nurses excel.  Nurses independent practice is drawing upon the best available medical knowledge, and also the knowledge, skills and values we bring to the patient encounter. In particular looking at the whole person and taking time to go beyond the physical to the social, the psychological, and the cultural factors.  So I’m really excited that the VA is leading this debate.  :33

Davidson says if successful, she anticipates more large organizations following suit. At Johns Hopkins, I’m Elizabeth Tracey

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March for Our Lives Co-Founder Quits, Says He’s Said Things He Regrets and Realizes He “Doesn’t Know Everything”

Good God almighty, there is hope for the Tide Pod generation after all.

Cameron Kasky, one of the Marjorie Stoneman Douglas High School students who co-founded the March for Our Lives and spent the majority of their senior year talking to CNN and being invited to lavish events put on by the gun-grabbing elite, has announced he is quitting the March for Lives and has, stunningly, learned that he doesn’t no everything.

We could have told all those kids that they were 17 and didn’t know everything, but I absolutely take my hat off to him and give him full credit for being willing to admit this to himself–most teenagers don’t realize they don’t know everything until they’re well into his twenties, so good for him. And I’m being completely serious, I really do admire the kid.

Trending: New Report From Politico Reveals Fox News Has Banned Rudy Giuliani

Speaking with Fox News Radio, he explained the regrets he has for things he said to Senator Rubio during that fateful CNN Townhall media circus, the respect he gained for gun owners and pro-life women while touring the country, and his interest in encouraging a bipartisan conversation.

On Senator Rubio, he says:

I’m very regretful of a lot of the mistakes that I’ve made along the way. One of the things I never really did was watch myself. If I was on a screen I kind of tried to run away from it. I’m not entirely sure why. But, looking back on that it’s like you said, you touched off on this very well in the intro, I’m not going to kick myself for it because I’m 17. Despite the fact that I thought I did at the time, I don’t know everything. But, I look back on that and I say, you know what, there were people who had just been buried and when you’re looking at somebody that you find might in some way have been complicit in this murderer obtaining the weapon it’s hard not to say something like that. But, I went into that wanting less conversation and more to embarrass Rubio and that was my biggest flaw.

He also said he regretting using the name of the young man who opened fire in his high school in Parkland, Florida on February 14, 2018, and wishes he hadn’t contributed to building the shooter’s celebrity.

While touring the country, he says, it dawned on him that a lot of our national debates come from a simple lack of willingness to listen:

This summer when March For Our Lives went on the summer tour that we embarked on I met that person in Texas whose got that semi-automatic weapon because that’s how they like to protect their family. I met the 50 some odd percent of woman who are pro-life, even though I thought it was preposterous that a woman could be pro-life and not pro-choice at the time. I learned that a lot of our issues politically come from a lack of understanding of other perspectives and also the fact that so often young conservatives and young liberals will go into debate, like I said earlier, trying to beat the other one as oppose to come to an agreement…I’m working on some efforts to encourage bipartisanship or at least discussion that is productive and help a lot of people avoid the mistakes that I made.

While it sounds like he’s far from turned against his buddies over at the March for Life, he says he’s completely removed himself from the organization because he no longer considers himself knowledgeable enough to participate in what he views as a “great responsibility.”

I left the organization and if I thought that my friends and the people I worked with couldn’t do it without me I would not have done that, but alas all of our efforts looking forward looked like they didn’t really need my involvement and while I could have helped it wasn’t crucial. You know what I thought in some of the platforms that I have for only the worst reasons is something I really believe in, because I’m a Spider man fan, and I can tell you with great platform comes great responsibility. I thought it was my responsibility to take all the things I was kicking myself for and to encourage others to avoid it.

Smart kid–ironically, I think he’s probably got a much more productive future than the rest of the kids associated with the March, who most likely still believe they know everything at 17.

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I intend to withhold all financial support for the "Bishop's Annual Appeal" until Bishop Zarama removes Fr. William Long from all pastoral duties. (Poll Closed)

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