A Resolution to Smile About

The many family gatherings and holiday parties are not only trying times for your waistline, but can also be quite tough on your teeth. Billions of candy canes are eaten each holiday season and each person puts away an estimated 12 pounds of premium chocolates.

But it’s not just the food.

Americans, on average, drink enough for every person to have 7 bottles of liquor, 12 bottles of wine and 230 cans of beer. All capped off with a customary glass of champagne on New Year’s Eve.

If you don't bother to make good decisions about what you are eating and drinking, or to properly clean your pearly whites afterward, you could end up with tooth decay, gum disease and possible tooth loss.

With this in mind, I want to share a couple of oral health tips that will help keep your smile intact this holiday season and into the next:

1. If you choose to drink wine, choose red over white. While many people think red wine is worse because of its staining power, white wine contains more sugar which is actually more harmful for your teeth in the long run. Regardless of which wine you choose to drink, you should always rinse your mouth out with water before you brush your teeth.

2. If you choose to drink spirits or liquor the opposite is true. You should actually choose the lighter or clear liquids to avoid higher sugar contents. However if you are mixing a clear alcohol with a sugary juice or other drink then you still aren’t doing yourself any favors. As with the wine, you should rinse your mouth out with water after you drink and before you brush your teeth.

3. You should always consume candy in moderation – sugar free if possible. But if you are choosing between a candy cane and a piece of chocolate, go with the piece of chocolate. Sticky candies are less likely to wash out from between your teeth with saliva and therefore get more time in contact with your teeth. This is also true for fruit cake.

4. No matter how exhausted you may be from hosting your family or attending your fifth holiday party in a row, always remember to brush your teeth before you go to bed. If all the acid from the food you ate gets 8 hours to fester in your mouth it can do a whole lot of damage that could have been prevented with 2 minutes, a toothbrush, and some floss.

Good dental habits throughout the holidays – and year round – will help make for a happier New Year. As you make plans for 2011 I hope you all will resolve to be better to your teeth because that’s something we can all smile about.

-Dr. Linda Vidone, Associate Dental Director for DentaQuest

Risky Business

I graduated from dental school 30 years ago and enjoyed many years of private practice. Working on the benefits side of dentistry as I do now has also been rewarding in many of the same ways. My son graduated from dental school this past summer and during his four years, I joined the faculty at Tufts and lectured about the business side of dentistry.

Although I have done some volunteer dentistry since leaving private practice, I hadn’t had a personal patient encounter in several years. That was before I was introduced to a young man (26 years old) a couple of months ago. He was wearing his army fatigues, even though he was now a civilian. My son is an Army dentist, so I started up a conversation.

This young man was suffering from multiple abscessed teeth from some poor decisions that he had made since high school. When I say suffering, I mean the kind of suffering that had caused him to try to pull out his own tooth with pliers. A few years ago, his teeth were fine. But following some drug abuse and lack of home care, his 26-year old mouth was in serious trouble. I connected him with program that would give him some care, but this young man was unable to keep the appointments because his employer would not give him the time off. A colleague in our office who maintains a dental practice one day a week offered to help this young man and opened her office for him on a Saturday.

Now I would like to make two points about this experience. First, returning to clinical dentistry is like riding a bicycle and we were able to help this young man over two Saturdays. The second point is I was struck by the sense of invincibility in young people—they believe they can take chances and nothing will hurt them. I was alarmed and saddened to see how devastating their decisions can be, even a few years later.

Not taking care of your teeth is risky business. Whether it is the overuse of sports drinks or sugary sodas, prescription drug misuse, lack of oral hygiene, playing sports without a mouth guard, or driving without a seat belt, the speed of dental decay and its lasting devastation can change a young person’s life forever. Maintaining good oral health takes very little effort. Don’t ignore it!

Kids think that dentures are only for grandparents. In this case, they belong to a 26 year young man.


Doyle Williams, DDS

Bionic teeth

Losing a tooth in adulthood isn't exciting as it was when we were young. In fact, adult tooth loss has serious consequences--like difficulty chewing food or not wanting to smile at school or work. Missing teeth can also weaken the overall structure of your mouth.

In the next few years, there may be a "bionic" option for replacing lost teeth: re-growing them. We have seen the technology work in animals and we hope it will be available for commercial use in the next decade.

Scientists have discovered stem cells in baby teeth and that may put our friend the tooth fairy out of a job. In animals, scientists have used scaffolding to re-grow teeth. Work on the human genome has identified a gene that may actually re-grow a duplicate tooth in your own mouth. This technology is still maybe years away from being realized, yet there is reason to believe that stem cells from baby teeth will eventually be used to grow your own teeth for replacement. Instead of putting teeth under the pillow, parents may be sending their children’s teeth to stem cell banks for cryogenic storage.

A viable option for a lost tooth today is the dental implant. (Incidentally, November is Dental Implant Month). These replacements not only act and feel like natural teeth, but they also offer solid, non-mobile support. It may take three to six months for your new implant to feel fully functional in your own mouth following an extraction of a tooth, but dental implants restore proper chewing functions, allowing you to be able to enjoy foods you love.

Read more about tissue regeneration for teeth at http://www.popsci.com/science/article/2010-05/new-technique-uses-bodys-stem-cells-regenerate-teeth

Oral Health at the Grocery Store

Time Magazine’s Healthland blog, reporting on a study in the Journal of Consumer Research, explained that paying for food at the grocery store with cash instead of with a credit/debit card leads to more careful spending and healthier food choices.

In Massachusetts, doctors at three health centers are writing prescriptions for fresh fruits and vegetables. They are giving coupons equal to around $1 a day for each member of a patient’s family to buy and eat fresh produce from local farmers’ markets.

What does this have to do with oral health? The mouth is the gateway to the body and the starting point for good health – oral and otherwise. What we buy and eat matters in maintaining healthy mouths and nourishing healthy bodies—for our young and not so young.

Researchers in the Journal of Consumer Research study followed the grocery shopping habits of 1,000 households over six months. People who used debit or credit cards (1) tended to make more impulsive food choices and (2) the impulsive purchases were more often than not unhealthy items like cookies, cakes, and chips and candy. [Beware: acidic and sugary drinks, cookies and chips are the exactly the kind of food items that encourage the growth of cavity-forming bacteria in the mouth.]

Physicians in Massachusetts community health centers are trying to reverse the fast food dynamic, particularly in lower income inner city patients. They are using produce by prescription to steer families away from low cost/low nutrition and often impulse items to healthier, yet slightly costlier fresh fruits and vegetables. The physicians are watching these patients to see whether the food adjustment affects eating patterns and other health indicators like weight, body mass index, and of course, fewer cavities and healthier mouths.

Shop thoughtfully. Minimize sugars and starches, fats and empty calories. Remember that what you buy and eat matters in maintaining your healthy mouth and your healthy body. Healthy food choices are the starting point in reversing the national trend to obesity in children and adults and laying the groundwork for healthier generations of Americans.

Read more:

Healthland blog http://healthland.time.com/2010/10/21/study-paying-cash-not-credit-leads-to-healthier-food-choices/#ixzz136CUzqUe

Health Affairs: http://content.healthaffairs.org/cgi/content/short/hlthaff.28.5.w822

DentaQuest Oral Health Center Named “Adult Preventive Practice of the Year” by the ADA

The DentaQuest Institute is pleased to announce that the DentaQuest Oral Health Center (OHC), an affiliated dental office in Westborough, MA, has been selected by the American Dental Association as the Adult Preventive Care Practice of the Year. DentaQuest Oral Health Center Dental Director, Dr. Peter Blanchard and Clinical Director, Dr. Joy-Ann Deane accepted the award at the 2010 ADA annual session in Orlando, Florida.

The Adult Preventive Care Practice of the Year Award recognizes a dental office which has demonstrated excellence and innovation through the combination of practical, preventive oral health care and ongoing patient education. Dental offices from all 50 states applied for the distinction.

The DentaQuest Oral Health Center is a multi-specialty group practice, offering routine care and cleanings, general dental care, dentistry for children, and state-of-the-art orthodontic and endodontic care. What puts the DentaQuest Oral Health Center at the leading edge is its focus on risk-based treatment. By identifying the risk factors unique to each patient, the center helps prevent and manage dental disease. In addition to providing the highest-quality oral health care, the DentaQuest Oral Health Center also strives to help patients understand and make the best decisions about their own oral health.

Science is helping us understand the nature of dental disease, especially the two main ones, tooth decay and gum disease. Because both are bacterial infections, we have the ability to treat them and achieve better oral health. The solution doesn’t always have to be “drill and fill.” By identifying and treating the disease in its early stages, the DentaQuest Oral Health Center’s staff is able to help the tooth “heal” and make it more resistant to future decay.

It is this mission to deliver cost-effective, appropriate dental care using scientific, evidence-based technologies and treatments that are tailored to the dental needs of each patient that caught the attention of the American Dental Association’s evaluation panel. And, it is the reason why other dental practices are turning to the DentaQuest Oral Health Center to learn about this new model of practice.

We are delighted to be working with a number of dental practices nationally, providing technical assistance to help their dental care providers implement proven prevention and disease management protocols.

Guest Post by Mark Doherty, DMD, Executive Director of the DentaQuest Institute.

Take the Candy, Leave the Cavities

Halloween is just around the corner and children across the country are counting down the days until they can knock on doors and load up on their candy supply. But when it comes to trick or treat, it turns out that the treats can actually be the biggest tricks of all.

While any candy should be consumed in moderation at any time of the year – sugar free if possible – there are other factors to be aware of so that the Halloween holiday doesn’t have lingering effects.

Halloween is a time for children to enjoy, but you don’t want them to be paying for it in dental pain down the road. Moderation is the key and parents are the gatekeepers. Parents should help their kids fight cavities by moderating the amount of candy they consume and lowering the amount of time sugar stays in contact with their teeth.

Sugar is a known, major cause of tooth decay and cavities. Even after the candy bars are devoured and your child’s themed bucket or bag has been emptied, sugar and plaque lurk in the crevices of your child’s teeth and cause cavities. If not removed by careful brushing, bacteria in the mouth will feed on the sugars and turn it into acid. This acid then attacks tooth enamel and causes tooth decay, i.e. cavities.

As a parent, it is important to make sure you have a clear understanding of what is okay to stay in the candy bucket and what should be tossed. Making sure that you have a chance to inspect your children’s Halloween loot before they dive in is extremely important.

Hard candies, like lollipops, can cause chipped teeth, choking, and the promotion of tooth decay, since they sit in the mouth for a long period of time. Look for Halloween treats that can be eaten quickly, like miniature candy bars. Sticky candies are also a red flag for oral health issues. When you get home from trick-or-treating, discard sticky candies like sugared fruit snacks, caramels, popcorn balls. It is hard for saliva to wash away these sticky sugars and they stay in the crevices of the teeth for long periods of time.

It is better for children to eat a serving of candy in one sitting rather than over time. Chomping on candy after school until dinner time will increase the amount of time sugar comes in contact with teeth. Instead, encourage your child to eat a small amount in one sitting followed by a glass of water and thorough tooth brushing. Once your child has eaten the goodies, make sure that your children use an age-appropriate fluoridated mouthwash every evening to strengthen their teeth and rebuild the enamel which helps prevent cavities.

Watching the amount of sugar we consume is good advice at Halloween and year-round for young and old alike. Regularly practice and encourage good oral health habits with your children, including brushing at least twice a day, flossing and visiting your dentist every six months to ensure the sugary villains don’t stick around on your children’s, or your teeth long after Halloween is over.

-- Dr. Doyle Williams

Questions About Mouth Rinse Products

There has been some buzz this week about the FDA’s warnings about false claims that certain mouth rinse products can reduce plaque, promote gum health, and prevent gum disease. While these mouth rinse products do contain sodium fluoride, an active ingredient that is effective in preventing cavities, it has not been proven to remove plaque or prevent gum disease.

As with losing weight, there are many easy fixes but we all know it’s the basics—regular exercise and proper diet—that really work. The same goes for taking care of your mouth -- total oral health care does not consist of only using mouth rinses that “do it all.”

Total oral care is brushing, flossing and rinsing – IN THAT ORDER.

Most people understand the importance of brushing, but total care is more than brushing alone. Total oral care also includes flossing AND rinsing. Rinses can be water, mouthrinse, fluoride rinse, and even chlorhexidine, if your oral care provider recommends it. Each option is more effective than the previous one -- but only after proper brushing and flossing. And from start to finish, the full routine takes just 3 minutes.

Do your mouth a favor – make total oral health care part of your daily routine.

Smiles for Life

I’d like to introduce you to a very useful online oral health resource from the Society of Teachers of Family Medicine. It is called Smiles for Life. You can check it out at www.smilesforlifeoralhealth.org. And it is FREE for anyone to use.

Smiles for Life was originally developed in 2005 to support physicians training in Family Medicine residency programs provide oral health education and preventive information to their patients. Today, Smiles for Life is the nation’s most comprehensive and widely used oral health curriculum for medical care providers-- including physicians, pediatricians, physician assistants, nurse practitioners, anesthesiologists, etc.

The DentaQuest Foundation has been a long time supporter of this project. In 2009, we provided a grant to the Society of Teachers of Family Medicine to develop a web-based, interactive 3rd edition of Smiles for Life. This state of the art curriculum is completely FREE. Anyone interested in better oral health can easily access the materials and learn on their own time and at their own pace.

Why is this important? The ADA recommends children get a first dental check up around the 1st birthday. However, a child will likely see his or her pediatrician as many as 5 times before the 1st dental visit. Primary care health providers can play an important role in educating patients on cleaning teeth and gums and advising parents on the dangers of allowing cavity-causing bacteria to linger in the mouths of their children. As the child grows, these visits are another opportunity to deliver preventive oral health education and early intervention.

Thanks to the Smiles for Life curriculum, increasing numbers of parents – young and not so young -- are getting essential guidance and prevention skills to help their families maintain good oral health throughout their lives.

Guest Blogging by Ralph Fuccillo, President, DentaQuest Foundation

Dr. Man Wai Ng, Oral Health Champion

This morning, I gathered with DentaQuest colleagues and others in Boston's health care community at Boston Business Journal's Health Care Champion Awards ceremony. I extend my congratulations to all 2010 Champions and especially to Dr. Man Wai Ng who was recognized in the category of Innovator. Dr. Ng is an important research partner with the DentaQuest Institute, focused on improving treatment for children with early childhood caries (cavities) .

Every day, Dr. Ng, Dentist-in-Chief at Children’s Hospital Boston, sees the tragedy of advanced cases of dental disease in very young children. She often talks about the children -- 5 years old and younger – who arrive at the emergency room in severe pain from tooth decay that has ravaged their baby teeth. In many cases, the children she sees have suffered for such a long time that the underlying disease has begun to erode their jawbones to the point where they may not be able to develop normal permanent teeth! In these cases, the only solution for these young children is often surgery.

Hospital-based dental clinics, like the one Dr. Ng leads at Children’s Hospital in Boston, care for a disproportionate number of very young, low-income, racial and ethnic minority children with the advanced tooth decay of early childhood caries.

The traditional way of treating extreme cases of early childhood caries is surgery in the hospital operating room. The treatment is difficult, extremely scary for children, very expensive, and very avoidable, especially when you consider that dental disease is almost 100% preventable. What's even sadder is that children with this advanced disease typically wait up to 6 months for an opening in the operating room. And as they wait, they are in significant pain. If you've ever suffered from a serious tooth ache, you know how uncomfortable this can be. The severity of mouth pain in these children impacts their ability to learn to speak, to eat, to play, and their overall quality of life. Although surgery restores the damaged teeth, it doesn't solve the root cause of the disease which is bacteria. Many children experience unacceptably high rates of cavity recurrence (23-57% within 6-24 months). Dr. Ng is working to stop the root cause of the disease by controlling the bacteria and break the cycle of childhood tooth decay.

Dr. Ng enlisted the DentaQuest Institute to underwrite a demonstration project that would enable her team at Children’s Hospital Boston and another team at St. Joseph Hospital for Children in Providence RI to test an alternative method of treating this disease. Dr. Ng’s focus is controlling the cause of dental cavities by eliminating the bacteria. She and her dental care team are involving the parent or caregiver with education and at home instruction as an equally important step in controlling the advance and recurrence of dental disease as the hospital treatment. After two years, the research teams are seeing remarkable success in reducing the frequency of operating room treatments and instances of reoccurrence the disease in these children.

Along with her work in the dental clinic at Children’s Hospital, Dr. Ng is a teacher and mentor for the next generation of dentists and pediatricians. She is proving that with education and prevention, children’s oral health can be improved, and at-risk children can return to a normal pain-free state. When this is done, costly, painful and invasive surgery can be minimized.

Dr. Ng’s focus on prevention is innovative, compassionate, and practical. It demonstrates that thoughtful changes to established care regimens that are based on good science do make a difference in stopping dental disease, improving the quality of life for at-risk young children, and reducing health care spending.

Today Dr. Ng thanked Children’s Hospital for recognizing the importance of oral health by including dental care among their services. We thank them too. And, we congratulate Dr. Ng for her great work, and for continued success in her cause to eliminate dental disease in children.

Guest blog post by Dr. Mark Doherty, Executive Director of the DentaQuest Institute

Sealants (yes)!

An article posted in the September 7 online issue of the journal Pediatrics, has stirred up a lot of media interest in the chemical BPA in dental materials such as sealants.

First let me state that dental sealants—the thin layer of plastic coating painted onto the surface of the teeth by your oral health professional – are one of the most effective tools in dentistry to prevent recurring dental cavities in children and teenagers.

The Pediatrics Journal article’s authors found that BPA is released only when certain chemicals in the sealants come in contact with saliva. BPA may be detected in saliva for up to 3 hours after the sealants are applied. How much is absorbed is not known.

You’ve probably heard of BPA -- the controversial chemical found in plastic food-storage containers and some water bottles. Earlier studies showed that its endocrine-disrupting, estrogen-like properties can pose health risks. Recommendations were made to reduce all exposure to BPA. That’s why the media has taken such an interest in this academic article.

I am concerned that mothers will only hear ‘BPA’ and skip getting this preventive dental treatment for their children.

The study’s authors explain that the exposure to BPA from dental materials is much smaller and less frequent than with the other sources. And there are common sense things that oral health professionals can do to reduce exposure to the chemical for their patients. They can use rubber dams to localize the teeth being worked on and prevent the resin from touching saliva. And, they can then wipe or rinse away any residue after treatment.

The bottom line is that because of the strong cavity fighting benefits of dental sealants and the limited exposure to BPA, the authors of this study do recommend that sealants continue to be used in pediatric dentistry.

And so do I.

Sports Drinks & Your Teeth

Back to school means back to sports, and back to sports means an increase in the consumption of sugary and acidic sports drinks. The popular energy drinks sipped on by children participating in after school activities to rehydrate and revitalize can actually wreak havoc on their teeth.

The combination of acidic components, sugars, and additives in sports drinks combine to erode the tooth’s surface, weakening the enamel that protects teeth from bacteria. The enamel erosion ultimately makes teeth more susceptible to bacteria and leads to hypersensitivity, staining, and tooth decay.

If you drink a sports drink, here are a few tips to keep in mind:

Don’t sip the drink throughout the day. - Drinking them quickly means less time for the sugars and acids to erode enamel.

Don’t swish them around your mouth. - That only increases the risk of erosion.

Use a straw. - So teeth aren’t immersed in or in direct contact with the sugars and acids in the beverage.

Resist the urge to brush your teeth immediately after finishing a sports drink. - Tooth enamel softens after consumption of acidic drinks, making teeth susceptible to more wear from the abrasives in toothpaste. Wait 45 minutes to an hour before brushing to give your saliva time to re-mineralize the tooth structure and neutralize the damage.

Seek regular dental care. - Tooth decay is the most common chronic childhood disease, five times more common than asthma. It’s also completely preventable with proper care. Your dentist can identify erosion, pinpoint the causes, and advise you on how to prevent further damage and more serious problems from occurring.

Wear a mouthguard! - It is rule number one when playing sports! Preventing injury to your teeth is as important as protecting them from decay and erosion.

Going Dental

By chance, I watched the program Jeopardy on television recently, and perked up when I saw the category Going Absolutely Dental. Here’s one of the ‘answers’

“Gnaw away with these, any of the four anterior teeth in the jaw…”

The question: What are incisors?

If you saw that show and played along at home, the correct question would have earned you $1,000!

How would you have responded to this one? “It ain’t cheap fiction; it’s the inner substance of the tooth containing veins, arteries & nerves.”

Or how about, “AKA gingiva, they are the firm tissues enveloping the necks of the teeth; betcha didn't know teeth had necks, did ya?”

It made me smile that the college contestants in the studio responded correctly.

A simple game of Jeopardy, proving that you never know when knowing about your mouth will come in handy.

A New Chapter for Prevention

You may not know it, but Congress made a historic investment in prevention when it passed the Patient Protection and Affordable Care Act (PPACA).

At a time when states are cutting deeply into their public health budgets, Congress set aside $500 million this year (and $2 billion in 2015 and every year after) for the newly established “Prevention and Public Health Fund”, which will support clinical activities as well as community-based prevention initiatives, such as the Education and Outreach Campaign for Preventive Benefits, a planned public-private partnership to raise awareness on preventive care.

It’s hard to overstate the importance of this commitment to prevention. However, it is incumbent upon policymakers and their community partners to use all funding wisely to support the most effective programs possible.

Here are a few tips for creating an effective prevention program that we’ve learned from the last 20 years of prevention in Massachusetts:

1. Effective health promotion efforts begin with the elimination of silos and collaboration across programs, agencies and stakeholders. Programs have to focus on individuals and communities alike and work in concert.

2. Prevention programs cannot rely solely on governmental funding. We need help from the private sector, NGOs and philanthropies as well.

3. Successful health promotion requires the participation of diverse local populations. Everyone needs to be involved.

4. Prevention planning requires up-to-date community-based data. So we can ensure resources are allocated efficiently.

5. Community coalitions cannot run on volunteers alone. Paid staff are necessary for a sustainable program.

As we work to support national health care reform, the public and the health community need to continuously position community-based primary prevention initiatives as a priority. After all, better health does not happen in isolation; it must be woven into the fabric of the community.

We can do better and, with this landmark commitment from the federal government, we will.

Guest blog post by Ralph Fuccillo, President, DentaQuest Foundation

Mission of Mercy - Wise County Fairgrounds, VA

I spent last weekend at the Mission of Mercy (MoM) in Wise, Virginia. You’ve probably seen news reports of MoM events – they are held in just about every state and are providing emergency health services to people who have no other options. The Wise County MoM-- in the remote Appalachian Mountains of Western Virginia – is one of the oldest and largest. DentaQuest has supported this effort for many years and it never fails to make a dramatic impression on all of us who participate.

Over the weekend, the Wise County fairgrounds became a sea of tents and seemingly endless lines of people waiting – first to get in, then to get a number, then to get evaluated, and finally to get time with a dentist, doctor, or eye doctor (all volunteers ). The temperature was well over 100 degrees every day, with little shade, and no running water. The volunteer clinical providers worked tirelessly with very few breaks. Dentists provided needed care – with no running water.

It is impossible to overstate the desperation that I saw. Although the gates to the fairground did not open until 5 am on Friday, cars were filling the parking lot as early as Tuesday. By 5:30 am on Friday morning, over 1500 people had walked into the fairgrounds – the maximum that could be helped in one day—leaving thousands more outside the gates, hoping to get in the next day. Organizers told them to come back at 6 pm to get a number for Saturday. Inside, the people who had numbers patiently endured the blazing sun, sitting on bleachers until it was their turn to be seen in the Triage area. By the time the event wrapped up on Sunday, close to 6,000 had received medical, dental and eye care services. There’s a slide show here [http://www.timesnews.net/article.php?id=9024958].

I helped in the dental area where the most common procedure was not fillings, it was extractions. Many were full mouth extractions. Only a limited number of dentures were available – so there was a lottery for them. One young woman – just 29 years old—had all her teeth extracted. She was happy to be out of pain, but didn’t win the lottery for dentures. Can you imagine 29 years old and no teeth? And she thanked us.

The faces and stories from Wise are with me. As the CEO of a company whose mission is improving oral health, the volumes of people seeking emergency dental care is a painful reminder that many are falling through cracks in our health system. Missions of Mercy events are only a stop gap on the way to a solution.

I did see one sign of hope -- only a few children seeking emergency care. As the dental benefits administrator for Virginia’s Medicaid program, DentaQuest has been working with our state partners to make sure that children on Medicaid get dental services. In the recent Pew Report on children’s oral health, Virginia met or exceeded the national benchmark for children 18 and under on Medicaid who get dental care. That is one step forward, but there is more work to be done.


Guest blog post by Fay Donohue, CEO, DentaQuest.

Bringing Oral Health Awareness to Capitol Hill

Many people think the Patient Protection and Affordable Care Act (Health Reform Bill) is only about reforming insurance to expand access to health coverage.

But that’s only half the story. The bill also contains many important provisions that will improve care coordination and access to critical preventive services, though they’ve gone largely unnoticed. The Kaiser Family Foundation gives a concise summary of some of the funded initiatives. Congress included another 52 unfunded programs whose futures are still under debate.

One such unfunded program is the Oral Health Public Education Campaign, championed by Senator Jeff Bingaman of New Mexico. The campaign is designed to raise awareness of the importance of oral health—particularly for young children from underserved populations.

Over the past few months, I have been working with Senator Bingaman’s office to help ensure this program is funded because, after all—what good are oral health services if no one knows about them?

Only one-third (33 percent) of mothers thought oral health was important for their infants, according to a survey by the American Dental Association (ADA). Additional survey findings reported by the American Academy of Pediatric Dentistry found that just 14 percent of parents realized that tooth decay in children can ultimately lead to the need for a root canal – even in infants.

With an estimated 1 out of 10 children reporting mouth pain from untreated dental decay, we have to do more to raise awareness.

The good news is that oral health literacy campaigns can help. The ADA reported that 78 percent of parents would take their children to visit a pediatric dentist before their first birthday, if only they knew oral health care early in life would lead to improved oral health as their children developed.

Getting that early care is critical for a child’s overall development, since we know children who have untreated dental disease face greater challenges learning, impaired nutrition, and even death.

I’ve been bringing this message to key members of Congress and will continue doing so until we, as a country, recognize the importance of oral health.


Guest Post by Fay Donohue, CEO, DentaQuest

Chipped, Broken and Bruised Teeth

I hear stories all of the time about people who have accidentally chipped or broken teeth while playing sports, horsing around with friends, or even from being bumped while drinking from a bottle. Others tell stories about chewing ice cubes and feeling a sharp pain on a back tooth.

If a tooth gets chipped or damaged – you want to see your dentist as soon as possible. Your dentist will examine the tooth to tell whether the nerve has been injured. If this is the case, you may need a root canal. Early detection may put off or even avoid the root canal for years.

When a tooth chips or cracks:

1. If you can find the chip of tooth, take it with you to the dentist. It may be possible to bond large chips back onto the tooth which keeps your same familiar smile. If the chip can’t be used, the dentist has lots of tooth-colored filling materials to make your tooth look as natural as possible.

2. If you need to drink something or rinse your mouth, try something lukewarm rather than cold or hot. This not only keeps you from screaming, but it may help protect the nerve.

3. If there is bleeding, hold a clean cloth on the area until the bleeding stops --- about 10 minutes.

4. Take an over-the-counter pain reliever and call your dentist.

Sometimes a tooth may be bruised from a traumatic blow. Watch it. You will need to see your dentist if the tooth gets sensitive to temperature or if it hurts as you eat. This pain is a sign that the nerve or ligament of the tooth may be injured.

In the example of the ice chewer, there may have been a weak spot on a molar and biting on the ice created a hairline fracture. (Physics note: the back of the jaw is a lever, like a nutcracker; it generates a lot of mechanical pressure that could create a fracture in a weak area of the tooth.) Afterwards, each time this person bit down on something with the injured molar, the crack in the tooth expanded, putting pressure on the nerve, and causing pain. Once the pressure was released, the crack closed and the tooth felt just fine.

Cracked teeth can be bonded or crowned to try to stop the pain. However, if you are still feeling pain when chewing, a root canal will be the next step. Unfortunately, some cracked teeth are not repairable; they end up being extracted and replaced with a bridge or an implant.

Injuries to Permanent Teeth

Last week, a friend’s child had a bike accident and a permanent front tooth was knocked out. Times like this call for cool and calm thinking. If the tooth is re-inserted in less than an hour, with the nerves and the blood vessels intact, there is a good chance that it will be successful. Here’s what you should do.

1. Stay Calm. Your child is probably scared and in pain. It is important for you to stay calm and reassuring. And, call your dentist.

2. Don’t clean the tooth – You don’t want to disturb the nerves and blood vessels on the tooth. Pick the tooth up by the crown.

3. An adult can try putting the tooth into his/her mouth. Be careful not to swallow the tooth, but an adult outside working or playing may not have anything to keep the tooth moist, so your mouth may work great in the short term.

4 If you are at home, put the tooth in a cup with milk or clean water.

5. Get to your dentist. Try to get the child and the tooth to the dentist within an hour. Call ahead to be sure that someone will be there to help you. You may be directed to another dentist or even to a hospital emergency room.

At the Dentist’s Office. The dentist will carefully clean the tooth put it back into the socket and may use a splint to hold the tooth in place. The tooth may require a root canal in the future.

If the tooth cannot be saved, all is not lost. Removable and permanent replacements can be made and an implant may be the ultimate solution.

Injuries to teeth, both baby teeth and permanent ones are very common. A broken tooth needs to be restored and a discolored tooth needs to be watched for swelling or pain.

Regardless of the type of injury, call your dentist who can give you advice specific to your situation.

And remember to wear a mouth guard when playing sports, biking or other times when injuries may occur.

Stay Cool and Hydrated

School is out! The hot weather has arrived and with it, the risk of heat-related dehydration. In the heat, our bodies tend to lose more water than usual, and that makes us more susceptible to dehydration. Watch for:

o Dizziness
o Headache
o Dry mouth or nose
o Nausea
o Vomiting
o Muscle Weakness

Dehydration can be dangerous. So if it is hot and you’re feeling any of these symptoms, get out of the sun and start drinking water. As a dentist, I recommend fluoridated water. Fill a water bottle with tap water and keep it with you when active and outside. Drinking fluoridated water not only helps you stay hydrated, it also helps your teeth. Check here to see if your public water system is fluoridated: http://apps.nccd.cdc.gov/MWF/Index.asp

Fluoride, a natural substance added to water, plays an important role in healthy tooth development and cavity prevention. Fluoride works by stopping or even reversing the tooth decay process, keeping tooth enamel strong and solid.

The United States Centers for Disease Control (CDC) considers community water fluoridation one of the 10 greatest public health achievements of the 20th century. They say water fluoridation may reduce tooth decay by 20-40%.

If your community’s water is not fluoridated, fluoridated bottled water is available.

Have fun throughout the summer. Remember to wear sunscreen. Sip water throughout the day. And choose fluoridated water to keep your body hydrated and your smile bright!

Mouth piercings: Let a healthy smile make the fashion statement

Tongue piercings, lip piercings, cheek piercings – they all seem to be a part of an innocent teenage fad of fashion and self expression. But, often overlooked are the heath risks associated with oral piercings, and there are numerous:

o Infection – The wound created by an oral piercing, the vast amount of bacteria in the mouth, and the introduction of additional bacteria from handling the jewelry creates a breeding ground for infection.

o Uncontrollable Bleeding or Nerve Damage – Numbness or loss of sensation at the site of the piercing can occur if nerves have been damaged. If blood vessels are punctured, prolonged bleeding can occur.

o Increased Saliva – Mouth jewelry often increases salivary flow which could result in temporary or permanent drooling. It can also result in difficulty chewing and swallowing food, and speaking clearly.

o Pain and Swelling – Oral piercings, specifically tongue piercings, often lead to pain and swelling which can be severe enough to block the airway and make breathing difficult.

o Blood Poisoning or Endocarditis – Due to the wound created by the piercing, it is possible for bacteria to enter the bloodstream and lead to the development or blood poisoning or endocarditis – an inflammation of the heart or its valves.

o Injuries to the Gum Tissue – People with oral piercings have a greater risk of gum disease than those without oral piercings. Mouth jewelry can come into contact with gum tissue resulting in injury as well as a recession of the gum tissue which can lead to loose teeth and tooth loss.

o Damage to Teeth – Teeth that come into contact with mouth jewelry can chip or crack.

o Choking – Mouth jewelry that becomes loose in the mouth can become a choking hazard. If swallowed, studs, barbells, or hoops can result in injury to the digestive tract or lungs.

So, before you consider an oral piercing, think about its affect on your oral health and overall health and talk to your dentist.

Skip the mouth jewelry fad and let a healthy smile make a fashion statement.

Men’s Health and Wellness: Oral Health

Good oral hygiene and regular dentist visits are important for everyone, but studies and surveys show that men are less likely than women to seek preventative dental care and often neglect oral health for years. In fact, one of the most common factors associated with infrequent dental checkups is just being male.

The average male is less likely to brush his teeth after every meal (20.5% compared with 28.7% of women). He is also less likely to brush his teeth twice a day (49% compared with 56.8% of women), and more likely to develop periodontal (gum) disease.

Periodontal disease is a result of plaque that hardens into a rough, porous substance called tartar. The acids produced and released by bacteria in tartar irritate the gums and create periodontal pockets that fill with even more bacteria which often leads to bleeding, red, swollen or tender gums, persistent bad breath, and loose or separating teeth. Researchers have also found a connection between gum disease and cardiovascular disease, which can place people at risk for heart attacks and strokes.

Things to keep in mind:

Do you take medications?

• Because men are more likely to suffer from heart attacks, they are also more likely to be on medications that cause dry mouth. Heart or blood pressure medications and antidepressants often inhibit salivary flow which increases the risk for cavities as saliva helps to reduce the cavity-causing bacteria found in your mouth.

Do you smoke or use tobacco?

• Statistics show that the average man will lose 5.4 teeth by the age of 72. If he is a smoker however, he can plan on losing 12 teeth by the age of 72.
• If you smoke or chew, you also have a greater risk for periodontal disease and oral cancer. Men are affected twice as often as women.
• The most frequent oral cancer sites are the tongue, the floor of the mouth, and soft palate tissues in the back of the tongue, lips and gums. If it goes undetected and is not treated in its early stages, oral cancer can spread and lead to chronic pain, loss of function, irreparable facial and oral disfigurement, and even death. More than 8,000 people die each year from oral and pharyngeal diseases. If you use tobacco, it is important to regularly see your dentist for cleanings and to ensure that your mouth remains healthy and cancer free.

Do you play sports?

• For those of you who participate in sports, you have a greater potential for trauma to your mouth and teeth. If you play contact sports, like football, soccer, and basketball, it is extremely important that you use a mouth guard to protect your teeth.

Despite your gender, it is extremely important that we all take care of our oral health. The following tips will help to improve your oral health and therefore your overall health:

• Use a soft-bristled toothbrush to reach every surface of the tooth. If the bristles on your brush are frayed, buy a new one.
• Replace your toothbrush every 3 months or after you have been sick.
• Brush your teeth with fluoride toothpaste twice a day for at least 3 minutes. This can reduce tooth decay by as much as 40%.
• Floss daily.
• Visit your dentist at lease twice a year for cleanings.

Congressman Elijah Cummings (MD) Salutes Maryland’s Oral Health Heroes

In 2007, when a 12-year old Maryland boy died from an untreated oral infection, collective outrage throughout the state started a revolution to fix oral health in Maryland. Today, Maryland is a national leader in effective and innovative programming that has improved access to care, particularly for those who are uninsured or underinsured.

To celebrate just how far Maryland has come, on June 4, Maryland honored six community leaders for their work in igniting change. Awards were presented to:

• Secretary John Colmers, Department of Health and Mental Hygiene who provided the high level leadership for change in Maryland,
• Dr. Harry Goodman, director of the Office of Oral Health at the DHMH who developed innovative programs that have enabled thousands of children to get basic oral health screenings, fluoride varnish and referrals to dentists through pediatricians,
• State Senator Thomas McClain Middleton and State Delegate Peter Hammen, each of whom supported significant and needed policy, funding, and legislative and political efforts to support proposed changes,
• Dr. Scott Wolpin, dental director of Choptank Community Health Systems who has developed an excellent model for a comprehensive community approach to oral health,
• Dr. Winifred Booker, a leader in Maryland dentistry and practicing pediatric dentist.

Each played a key role in helping communities across Maryland better address the need for regular access to quality oral health care.

Speaking at this celebration, Congressman Elijah Cummings recalled the memory of Deamonte Driver, saying the untimely death of the 12 year old boy from untreated dental disease, is real and raw to him. He could have been Deamonte Driver, growing up thinking it was normal to have dental pain and decay. In congratulating the 2010 Heroes, Cummings observed that each Hero brought “skill to the table and compassion to the task.” He thanked them for "bringing life to life" and reminded the audience that work has to continue so this kind of tragedies doesn’t happen again. It is important to get this message out to public that the time to get dental care is not only when a child is in pain is critical.

This 1st Oral Health Heroes Celebration was hosted by the Maryland Dental Action Coalition (MDAC) with support from the DentaQuest Foundation. The work doesn’t end here; as someone in the audience said, “MDAC needs to act like the “Terrapin” who sticks its neck out and never moves backward.”

I have no doubt that it will.

Guest Post by Ralph Fuccillo, President of the DentaQuest Foundation

Maryland Hosts First Oral Health Heroes Celebration

On June 4, the Maryland Dental Action Coalition (MDAC) will host Maryland’s first annual Oral Health Heroes celebration at the National Museum of Dentistry in Baltimore beginning at 9am. The agenda includes a panel discussion, “Closing the Gap: Making Oral Health Accessible, Affordable, and Achievable,” followed by the presentation of awards. I appreciate the opportunity extended to me by the MDAC to moderate the panel.

The Maryland Dental Action Coalition* is an interesting story about how a community came together in response to tragedy. The group was first established as the Dental Action Committee in 2007 by Maryland’s Secretary of Health and Mental Hygiene John M. Colmers in response to the tragic death of 12-year old Deamonte Driver from an untreated dental infection. The first goal of the Dental Action Committee-- a remarkable team of legislators, policy makers, health administrators, and local dental practitioners from across Maryland-- was to establish policies, practices and public education initiatives aimed at preventing such a tragedy from happening again. In the span of a few years, Maryland has become a national model for constructive change. I can only image how difficult it must be to select just a few of the remarkable individuals working on behalf of better access to prevention and oral health care throughout Maryland for recognition this Friday.

I am looking forward to hearing the insights of the well-informed and energetic panel that the MDAC has assembled:

• Catherine Dunham of the Children’s Dental Health Project
• Dr. Leslie Grant, Past President of the National Dental Association and Chair of the Legislative Committee
• Dr. Norman Tinanoff, of the Department of Health Promotion and Policy of the University of Maryland (and a member of the DentaQuest Foundation’s Board of Directors)
• Laurie Norris, Campaign Manager for the Pew Charitable Trust’s Children’s Dental Campaign
• Barbara Klein, Associate Vice President, Government and Community Affairs for the University of Maryland.
  

I anticipate a lively discussion on the state of oral health in Maryland, what is on the horizon to continue the progress Maryland has made, and how oral health access and oral disease disparities will be addressed in national heath reform. If you are near the National Museum of Dentistry on Friday morning (June 4), join us for this unique celebration of oral health in Maryland.

And check back next week for news from the event.

*The Maryland Dental Action Coalition has a 2009 grant from the DentaQuest Foundation to support its transition to a sustainable statewide oral health coalition.

Guest Post by Ralph Fuccillo, President, DentaQuest Foundation

Recognizing One of Our Own

This June 5 and 6, the AIDS Walk in Massachusetts celebrates a milestone--25 years. On the occasion of this silver anniversary, the AIDS Action Committee is recognizing 25 people whose contributions have been critical to the fight against HIV/AIDS in Massachusetts and beyond. DentaQuest’s Ralph Fuccillo, President of our Foundation, is one of them.

Ralph is being honored for bringing the right people together to get things done. You can read the very nice profile of Ralph’s impact here.

In all that he does for DentaQuest and for the organizations to which he lends his name and support, Ralph Fuccillo is a connecter and consensus seeker. He is one of the activists who changed the course of prevention for AIDS.

We are very fortunate to have Ralph working just as hard today to get the right people to lend their support to our mission of improving oral health in communities of need across America.

Guest Blog post by Fay Donohue, DentaQuest CEO

Age Strong! Live Long: Oral Health and Older Americans

May is Older American’s Month. In celebration of this year's theme, "Age Strong! Live Long" I ask all my readers – Have you had a dental health check up this year?

As you can see from this chart, the oral health of older adults is getting better. Good oral health makes life better – it helps us speak, smile, smell, taste, chew, and swallow - and it keeps us looking younger! Preventable oral diseases – tooth decay (cavities), gum disease, and oral cancer - cause unnecessary pain and disability for millions each year.

We think of tooth decay (cavities) as a problem for children and adolescents. But older adults also get cavities too. This can be treated.

It is more likely that older adults experience periodontal or gum disease –gums get puffy and bleed, teeth become loose, chewing is difficult or painful, and food choices get softer and less nutritious. Tooth loss is not necessarily a part of aging. Gum disease is an infection caused by bacteria that gets under the gum tissue and begins to destroy the gums and bone. If you catch this early, it can be treated. But, if you ignore the symptoms and do nothing, you may loose teeth.

Another reason to have puffy and bleeding gums checked out is that gum disease may also be connected to other health problems such as diabetes, heart disease, and stroke. If you have any of these symptoms, talk to your dentist or physician.

Getting an oral cancer screening each year is another good reason to see your dentist. Every day hundreds of people are diagnosed with an oral cancer; 1 person dies every hour of every day from oral cancer. A screening is easy and painless; survival rates improve with early detection.

Make following guidelines from the Centers for Disease Control part of your daily routine.

1. Drink fluoridated water and use fluoride toothpaste. This is good protection against tooth decay at all ages.
2. Brushing and flossing every day reduces bacteria under the gum tissue and helps prevents periodontal disease. US News and World Report says flossing is one of 10 health habits that help you live to 100. A New York University study showed daily flossing reduced the amount of gum-disease-causing bacteria in the mouth-- bacteria that can enter the bloodstream and trigger inflammation in the arteries, a major risk factor for heart disease.
3. Visit your dentist every year --to maintain the overall health of your teeth and mouth and to detect pre-cancerous or cancerous lesions early in their development.
4. Avoid tobacco. Smokers have a 7 times greater risk of developing periodontal disease than nonsmokers. Spit tobacco also increases the risk of tooth decay. Dental researchers found that on average, 34% of the weight of pouch tobacco is some kind of simple sugar -- either glucose or sucrose!
5. Limit alcohol. Drinking excessive amounts of alcohol is a risk factor for oral and throat cancers. Alcohol and tobacco used together are the primary risk factors for these cancers.
   

Oral health matters – at every stage of your life.

A National Focus on Public Health Dentistry

DentaQuest just returned from the 2010 National Oral Health Conference. In what may be a sign of an improving economy and perhaps of the heightened interest in oral health as a result of health reform, this was one of the best attended conferences in recent memory, with 800 individuals and 30 exhibitors involved in 5 days of programming. Held in the gateway city of St. Louis, the 2010 conference involved a very broad spectrum of dentists, dental hygienists, health researchers, dental and health educators, legislators, and public health officials all engaged in the important work of improving the oral health of the American public.

DentaQuest had several opportunities to talk about the work we’re doing to improve oral health.

Using the DentaQuest Institute's recent quality improvement work for the treatment of Early Childhood Caries (ECC) as an example, we talked about the success we have had with an evidence-based, risk-based disease management approach (chart above) that is similar to the concept of chronic care management of medical conditions. Scroll down to our March blog post on our Early Childhood Caries Initiative to learn more. The results of this pilot are impressive and we are looking forward to get other dental practices to use this model in 2010.

Our Safety Net Solutions team introduced an innovative online learning center at www.snsportal.net. The SNS Portal is part classroom, part library, part chat room, and part town square – and 100% tailored to the information needs of clinical care staff and administrators of safety net dental programs. Safety Net Solutions Program Director Dr. Mark Doherty gave a very well received presentation on surviving the economic downturn for safety net dental providers. It will be reprised as a webinar through the online learning center. Visit the online learning center for dates and registration details.

DentaQuest Foundation President, Ralph Fuccillo, spoke to conference attendees about philanthropy's important leadership role in oral health. And, the Foundation’s Director of Programs and Policy, Dr. Michael Monopoli, discussed the role of foundations in supporting programs that are making system-wide changes to improve oral health.

The DentaQuest Institute is the only national, non-profit providing clinical care, practice management and technology solutions that help oral health care providers improve oral health. The DentaQuest Foundation is the largest national philanthropy dedicated solely to oral health.

I happen to think that the greatest benefit from the National Oral Health Conference is the opportunity for our team to connect with dental public health leaders from across the United States. It makes us better at the work we do with partners across the country in developing and implementing more effective approaches to preventing and managing oral disease.

Guest Post by Brian Souza, Managing Director of the DentaQuest Institute

Oral Cancer Facts

Since this is Oral Cancer Awareness month, I wanted to start and end the month with some thoughts on this collection of cancers. I was recently asked to talk about oral cancer on one of our local television stations and so I contacted the Oral Cancer Foundation for some information. I talked with their Director who is an oral cancer survivor of 11 years. He was a pleasant person to speak with and had lots of valuable information to share. Among his statistics:

1. 110 people every day are diagnosed with an oral cancer
2. 1 person dies every hour of every day from oral cancer
3. Anecdotally, on the oral cancer foundation survivor list, about 1/3 are under 30 years of age
4. There seems to be a correlation with the HPV virus and oral cancers
5. In 2007 oral cancers rose 11%
6. Survival rate is good if found early, but overall about a 55% survival after 5 years

The signs of possible oral cancer lesions inside your mouth include both “raised” and “sunken” lesions, changes in coloration, hardening lesions and lesions that bleed easily. These changes should have been present at least 14 days before you start to worry, and your dentist is a great place to start for a diagnosis.

Always feel free to talk to your dentist about what to watch for and ways to prevent oral cancer.

Massachusetts has an oral health plan

The plan, presented at the Massachusetts State House by the Better Oral Health for Massachusetts Coalition on April 12, is the result of over a year and a half of work by a dental care providers, program sponsors, lawmakers, state officials, insurers, health advocates, policy leaders, and consumers, in communities from Cape Cod to the Berkshires.

The goal of the state Oral Health Plan is to improve the system of oral health services in the state through a strategy that includes increasing access to preventive services, broadening the public’s understanding of oral health, developing the oral health workforce, and strengthening disease surveillance. The plan emphasizes cost-effective strategies and public-private partnerships at the local, regional and statewide levels.

The Better Oral Health for Massachusetts Coalition was formed in 2008 in response to data provided in 2008 report by the Catalyst Institute’s report, The Oral Health of Massachusetts. This report found gaps in access to preventive oral health services across Massachusetts. For example, 48% of children under the age of 9 suffer from tooth decay and 1 in 10 children from low-income and minority families reported mouth pain while at school. Untreated tooth decay can inhibit a child’s ability to learn, speak, and eat, and result in lower educational attainment and poorer overall health.

I had the pleasure to serve as master of ceremonies at the launch of the plan. Speakers representing state government and the health care community spoke about the importance of oral health and its connection to overall health.

The DentaQuest Foundation has been the primary supporter of the Better Oral Health for Massachusetts Coalition through in-kind and financial contributions. View the plan at www.massoralhealth.org or, at www.dentaquestfoundation.org/resources/reports.php.

Guest post by Ralph Fuccillo, President, DentaQuest Foundation

Acid Reflux and Oral Cancer

The survival rate for people with oral cancer has not shown much improvement over the past several decades and we should discuss some reasons for that.

In general terms, mouth cancers have about a 50% survival rate after 5 years. Most physicians believe this is because the cancers of the mouth are diagnosed later than other cancers, mainly because the public ignores many early signs.

As a dentist, I am expected to perform a 90-second oral cancer screening for patients. In this screening, I look for color changes in the tissues or small ulcerations in the oral cavity. Many lesions are found at the base of the tongue and under the tongue – places most people never look at in their own mouths.

A dentist needs to take a piece of gauze and pull your tongue, twisting it from side-to-side to get a good look under and behind the tongue. There are other tools available to dentists today for biopsying these ulcerations to tell if they are cancerous. One popular tool uses a rinse and blue light to show ulcerations. This tool does not give a diagnosis of the tissue changes, but it makes them easier to find. For those with insurance, the visual oral cancer screening is included as part of the oral evaluation performed by dentists, and should not be charged separately.

The leading causes of oral cancer include the use of tobacco and alcohol, but certainly it can strike anyone. My mother died nearly 40 years ago from a form of oral cancer related to acid reflux and which is almost completely preventable today. Prior to her death, I was not aware that acid reflux can irritate the esophagus until it becomes malignant. Common associated diagnoses are GERD and Barrett’s esophagus. GERD is a term for acid reflux; Barrett’s esophagus is the pre-cancerous esophagus caused from acid reflux that then becomes irritated and later may become malignant. Your dentist may be able to recognize untreated Barrett’s from signs of erosion on the teeth from the acid and may alert you to have a conversation with your physician.

This month (April) is oral cancer awareness month. I wanted to remind you to make sure your dentist pulls and twists your tongue at your next visit.

Reform Measures for Oral Health

Wrapping up a prolonged national discussion on health care, Congress approved health care reform legislation (H.R. 3590 and H.R. 4872). President Obama signed the Affordable Health Care for America Act into law. During the debate, DentaQuest spoke out to make sure there would be oral health provisions in the final law.

The new law will offer essential dental benefits for children as part of their overall health plan. These covered dental care visits should provide adequate oral care and preventative measures for all children.

All Americans should become better informed about how oral health improves their general wellbeing through programs that educate the public about the importance of oral health. We anticipate more funding for research in dentistry and greater use of proven prevention measures like dental sealants and community water fluoridation.

The reform bill addresses access to dental care with provisions targeted to expanding the number of professionals within the industry. One way is to support minorities who wish to undertake careers in health. The Centers of Excellence (COE) program will enhance recruitment, training, academic performance, and other support; there may be scholarships for disadvantaged students who work in medically underserved areas as primary care providers, and loan repayments for individuals who serve as faculty in eligible institutions through the Health Professions Training for Diversity.

Current dental care providers may become eligible for funding to further their education in the field of dentistry; this means more qualified dentists to treat more individuals who receive coverage via the healthcare reform bill.

Finally, the Affordable Health Care for America Act allows for standalone dental plans, like DentaQuest, to be offered through the new health exchanges. Today, stand alone dental plans provide 97 percent of dental coverage and work to control costs with an emphasis on preventive services. The bill also exempts dental coverage from the premium amounts subjected to the “Cadillac plan” excise tax.

Guest Blog post by Fay Donohue, DentaQuest CEO.

The Silent Epidemic: Early Childhood Caries

The DentaQuest Institute recently had the opportunity to participate in the National Initiative for Children’s Health Quality’s (NICHQ) Annual Forum for Improving Children’s Healthcare and Childhood Obesity Congress. NICHQ is a great organization doing important work to make sure all children receive the high quality healthcare they need. Dr. Man Wai Ng, Chief of the Department of Dentistry of Children’s Hospital Boston and I gave a presentation about some interesting work we are doing with Early Childhood Caries.

Early Childhood Caries (ECC) – or aggressive tooth decay in very young children – is something that we should never have to talk about. ECC, like all dental disease, is almost completely preventable. But caregivers need to be aware of the right things to do for their children from the moment the youngster gets his or her first teeth. Preventing ECC is why dentists recommend that children get their first oral health check up around their first birthday, why we recommend brushing a child’s teeth every day, and why dentists advise against giving children bottles of anything other than plain water before a nap or bedtime.

Too many children don’t get the preventive care they need and deserve early in life; too many end up in hospital-based dental clinics where the only solution is to treat the dental disease surgically in the operating room. The numbers of children in this situation are surprisingly large and many must wait in pain for months to get time in the hospital’s operating room. Even after treatment, there is often a high rate of recurrence of the cavities. Early childhood caries is painful to the child, and if untreated, can impact the proper development of permanent teeth. The results are eating and speech problems that limit the child’s ability to grow, to thrive, and to enjoy a normal life.

For the past 18 months, Dr. Man Wai Ng of Boston Children’s Hospital, Dr. Dan Kane of St. Joseph Hospital for Specialty Care in Providence, and the DentaQuest Institute have been testing a different model for treating ECC. We’ve been using an evidence-based, risk-based disease management approach adapted from the concept of chronic care management of medical conditions. Our emphasis has been on educating the caregiver as a first line of defense in reversing the cycle of the child’s dental disease. I’m happy to say that we have seen some very positive results. Given the success of this initial effort, we are working on plans to further expand this chronic care model and we look forward to partnering with clinical partners across the country on more effective approaches to prevent and manage oral disease in children.

- Guest blog post by Dr. Alex White, Director of Analytics, DentaQuest Institute.

Massachusetts’ 2010 Oral Health Heroes

Each February, the DentaQuest Foundation is pleased to join the Massachusetts Legislative Oral Health Caucus, Health Care for All, and other key partners at the Massachusetts State House in a special recognition event. The Oral Health Heroes Ceremony highlights the “Watch Your Mouth” oral health awareness campaign in Massachusetts, and celebrates Oral Health Heroes in the Commonwealth. This year marks our 5th Annual Oral Health Heroes celebration. As Master of Ceremonies, I had the honor of recognizing several individuals in the Massachusetts state legislature and in our communities for outstanding leadership in improving the oral health of Massachusetts’ residents.

This year’s legislative honorees are Senator Steven Panagiotakos and Representative Ellen Story. Senator Panagiotakos, while serving in a leadership role as Chair of the Senate Committee on Ways and Means, was instrumental in preserving dental benefits for adults on MassHealth (Medicaid) in the FY2010 budget. Representative Story has consistently stood up for oral health, signing on to many oral health bills and testifying at many hearings at the State House – all to promote oral health.

We also honored Hugh Silk, M.D., and Herlivi Linares, D.D.S. two members of our medical and dental community for their significant leadership in oral health. Dr. Silk is a family physician at Hahnemann Family Health Center in Worcester. He has been a longtime advocate for addressing oral health during well child visits, and has worked to include oral health in the education of residents.

Dr. Herlivi Linares, Associate Dental Director of Lynn Community Health Center’s Dental Services, provides crucial oral health services to her community which includes many low-income adults covered by Medicaid or the Commonwealth Care subsidized program.

Congratulations to all the 2010 Massachusetts Oral Health Heroes. I look forward to our continued work together as a community to bring Massachusetts residents greater access to oral health services and set an example for other states.

Blog post by Ralph Fuccillo, President, DentaQuest Foundation.

Let’s talk about the oral health of America’s children

Today, the Pew Center on the States released The Cost of Delay: State Dental Policies Fail One in Five Children, a study of how the 50 states are responding to the needs for prevention services and access to dental care for America’s children. The DentaQuest Foundation, with the W. K. Kellogg Foundation, provided support for the development of this report to increase awareness of the important things states can do to ensure good oral health for children.

There are an estimated 17 million (i.e. one in five) children who go without dental care each year, according to the report. Children from low-income households suffer the most— they are twice as likely to have untreated decay as their more affluent peers and are a fifth less likely to receive care.

Fortunately, unlike many health problems, the challenge of ensuring children’s dental health is one that can be overcome. With education, prevention services and access to care—dental disease is nearly 100% preventable. Investing in healthy kids early on pays off throughout their lives. The negative effects of untreated dental disease start early, impacting a child’s learning, speech, nutrition and success in education. Later in life, untreated disease impacts an individual’s ability to get and keep work and maintain good personal health.

In 2003, the U. S. Surgeon General challenged America’s health leaders to educate the general public and policy makers about the need for good oral health and to identify and replicate effective programs that will improve the oral health of Americans. The Pew report highlights proven efforts that are working in these key areas:

• Preventing dental problems in the first place
• Ensuring children have access to dental care
• Tracking progress in each state when it comes to children’s dental health.

One solution that is making a difference today is school-based dental programs. Across the U.S., school-based programs are bringing communities, dental care providers and educators together to provide prevention services--such as screenings, protective sealants and fluoride varnish at school, where children spend most of their day. Many children don’t see the dentist because the parent/caregiver doesn’t recognize oral care as a need, or the parent can’t take time off from work or doesn’t have transportation to get the child to the dentist. School-based programs solve all these problems, and provide an added benefit of pairing children, and their families, with accessible comprehensive care at a local community health center.

The DentaQuest Foundation hopes the data in this 50 state report will become a baseline upon which each state can build and move forward. I am hopeful that over the next few years we will see great progress in how we as a nation respond to the oral health needs of our children.

Guest post by Ralph Fuccillo, President, DentaQuest Foundation.

Healthy Moms; Healthy Children

You might have seen this news item recently: a 35-year old woman, who had gingivitis (gum disease) delivered a stillborn baby at 39 weeks of pregnancy. (Full term is 40 weeks.)

Gingivitis (tender, swollen gums that bleed easily) among pregnant women is not uncommon because of their high hormone levels. Usually, the condition reverses after the pregnancy is over.

Dentists check all of their patients for signs of gingivitis. The cause of this infection is bacteria. Usually, with good patient education, regular check ups and cleanings at the dentist, and an emphasis on daily brushing and flossing, the disease can be controlled. However, if your dentist recommends further treatment the best time is before you get pregnant.

Back to the woman who delivered the stillborn baby. An autopsy revealed that a bacterial infection was the cause of death. And the type of bacteria --- was one commonly found in the mouth.

What is going on? A research team at the Case Western Reserve University’s dental school may have the answer to why some women go into early labor or deliver early. Using DNA technology, Dr. Yiping Han and the team in the department of periodontics found previously undetected bacteria from the mouth in the amniotic fluid of women who went into preterm labor. Read more about this at http://blog.case.edu/case-news/2010/01/22/oralbacteriamombaby.

How does bacteria usually found in the mouth make it to the placenta? One thought is that the bacteria enter the bloodstream when the gums bleed. Bleeding gums, a symptom of gingivitis, create an easy path for bacteria released by brushing or flossing to get into the bloodstream.
Normally, the body’s immune system can fight off low levels of oral bacteria in the blood. However, pregnant women are more vulnerable to infections. And, there aren’t many immune cells in the placenta to stop bacteria from multiplying once they get in.

The lesson from this story is that women need to take care of their oral health because it impacts them and their children.

Pregnancy gingivitis is pretty common. Ideally, women should have their teeth examined and cleaned before they become pregnant, and then they should take extra care to brush and floss during pregnancy. Once their babies start to get first teeth, mothers should be sure to make taking care of teeth a part of the child’s daily routine. That is the first step to having a healthy smile today and to keeping mom and baby’s smiles healthy for life.

Guest Blog Post by Dr. Linda Vidone, Associate Dental Director for DentaQuest. Dr. Vidone is a practicing periodontist.

Washington’s Unseen Oral Health Debate

President Obama’s state of the union address the other night sent a clear message that the health care reform debate will continue in some form. Whatever happens, lawmakers should not overlook what happens above the neck—the importance that oral health plays in an individual’s overall health.

The good news is that today, more than 174 million Americans have dental coverage, and 97 percent of that is provided by stand-alone and dedicated dental insurance companies. Dental insurance companies have a singular focus that has resulted in affordable coverage—the average individual plan is around $30 a month—with an emphasis on preventive services like sealants and fluoride treatments.

The old adage—“if it ain’t broke, don’t fix it”—should apply here. The system works. Yet there are proposals in Congress that would force up to 50 million children to switch dental coverage from a stand-alone plan to one administered by a medical insurer (like HMOs). This overlooks the benefit of stand-alone plans and would put Americans’ oral health needs at risk.

Congress should move forward to overhaul our health care system, but we shouldn’t attempt to ‘fix’ what already works in providing Americans high quality oral health care.

Guest Blog Post by Fay Donohue, President and CEO of DentaQuest

Predictions Can Come True in Dentistry

I see lots of predictions at this time of year and it is interesting to see how close they are to reality.

In dentistry, new predictive tools that indicate whether a person will get cavities are very close. New technology is helping dentists move from treating disease, that is waiting for a cavity to form and repairing the tooth, to emphasizing prevention and wellness -- by determining which individuals are at greater risk for cavities and showing them simple interventions that may save them from getting dental disease.

Researchers have perfected a technique called ATP-bioluminescence that measures the energy source for the cavity-causing bacteria in an individual’s mouth. And interestingly, the results are as accurate --and possibly even more accurate -- than sending mouth swabs to a lab for analysis. The energy source is called ATP.

A hand-held test is now available for use in the dentist’s office that measures the amount of ATP in the cavity-causing bacteria of a patient’s mouth with an instrument about the size of a television remote control. As part of a routine exam, the dental hygienist simply takes a swab sample from the patient’s teeth and in fifteen seconds, the device analyzes the energy in the bad bacteria. Counts below 1,500 are seen as “good” and those reaching 10,000 are “bad”.

Bad does not mean that you are doomed to a mouthful of cavities. But it will alert your dentist that intervention is needed. The first step may be to reduce the acidity in your mouth, and therefore reduce the energy available to feed the cavity-causing bacteria. Your dentist may suggest brushing with baking soda toothpastes or using specially formulated mouth rinses which reduce acid levels and help reduce or eliminate cavities for you.

Dentists also strongly recommend the use of prescription fluoride gels and rinses which help small cavities heal themselves. Another good idea is to use products (like chewing gum) sweetened with xylitol instead of sugar because xylitol has been shown to reduce the risk of forming new cavities.

ATP-bioluminescence looks promising. It will be interesting to hear what dental offices think about this new technology as way to help patients prevent dental disease.

I am always on the look out for details about new technological advancements in dentistry, especially those which promise to help patients and their dentists prevent disease. There is currently some very innovative research underway that may lead to surprising health outcomes. I’ll be bringing them to your attention as I learn more about them.

For now, you can see how the ATP bioluminescence meter works at: http://www.carifree.com/media/CariFree_Demo.html.