Using Performance Measurement to Improve Oral Health and Patient Care

This week, I have the pleasure of recognizing my colleague Dr. Rob Compton, who was recently appointed to the American Dental Association’s (ADA) Dental Quality Alliance (DQA) Advisory Committee on Research and Development of Performance Measures.

Dr. Compton, vice president of quality improvement for DentaQuest, is a nationally recognized expert on evidence-based oral health care and cost management methodologies. In 1999, Dr. Compton opened DentaQuest’s model dental office in Massachusetts. Its goal has been to deliver cost-effective, appropriate dental care using scientific, evidence-based technologies and treatments that are tailored to the dental needs of each patient. Today, under the direction of Dr. Peter Blanchard, the DentaQuest Oral Health Center is a thriving multi-specialty dental office—and the American Dental Association’s Adult Preventive Practice of the Year. Disease management and patient education are at the heart of its business and clinical systems. And for patients, that means healthier mouths, keeping their teeth for life, and much less need to drill and fill. The DentaQuest Oral Health Center has become a model for other dental offices who want to emphasize disease management in patient care.

Dr. Compton has brought the same thoughtful care and attention to quality improvement for better patient outcomes to DentaQuest’s dental benefit plan designs. He has encouraged DentaQuest to cover new services once they have been shown to have real impact on slowing the progression of dental and gum disease, particularly in higher-risk patients. His appointment to this ADA committee is acknowledgement of DentaQuest’s role as a major stakeholder and subject matter expert in high quality oral health benefits that emphasize cost and quality and which lead to improved patient outcomes.

The DQA was established by the American Dental Association in 2008 at the request of the Center for Medicare and Medicaid Services (CMS) which is also a co-sponsor. Its mission is to advance performance measurement as a means to improve oral health and patient care and safety through a consensus-building process.

Sweet Breath and Healthy Mouths for Valentine’s Day!

A Valentine’s Day kiss is good for your health! A nice smooch will stimulate saliva production. That helps prevent tooth decay. As you get ready to pucker up, take these steps to be sure your breath is sweet.

Bad breath, or halitosis, can be embarrassing. The best way to prevent bad breath is to eliminate the potential causes. Bacteria lingering in your mouth from food or infections can create odors (and lead to decay). Brushing and flossing your teeth twice a day is a good start. Also clean your tongue –it can retain bacteria. A gentle and thorough cleaning with a tongue scraper or toothbrush can remove lingering food particles.

Foods play a role in lingering bad breath. Most people know they should avoid foods with strong smelling ingredients, like garlic or onion. Did you know that oils from some cheeses and soft drinks are absorbed into your lungs and the smell is given off in your breath for a while! Foods such as apples or oranges contain helpful enzymes that naturally remove bacteria. Crunchy foods like carrots or celery help stimulate the flow of saliva which also helps get rid of odor causing bacteria. Chewing on parsley or mint leaves can also help freshen your breath.

Sometimes the cause of halitosis is a dry mouth and not food. Saliva is a natural cleaner for the mouth, helping to remove food and other particles that may cause halitosis. Some people don’t produce enough saliva to keep their mouth wet.

A side-effect of some medications, such as antihistamines, tranquilizers, and various blood pressure medicines, may be a decrease in the flow of saliva (in children and adults). Diseases like Sjögren's Syndrome, HIV/AIDS, diabetes, and Parkinson's disease can also cause dry mouth. Cancer patients may find salivary glands are impaired after exposure to radiation treatment. Chemotherapy drugs can make saliva thicker, leaving the mouth feeling sticky and dry. If any of these symptoms sounds familiar to you, talk to your dentist and physician. They may be able to suggest alternative medications or prescribe a medicine that helps your salivary glands work better.

People experiencing dry mouth can stimulate the flow of saliva with sugarless gum or candy. It is also a good idea to drink six to eight glasses of water a day. Try to avoid alcohol and tobacco; both are “drying agents” which remove saliva from your mouth. Ultimately that can lead to an increase in bad breath and a higher tendency to tooth decay.

Adding a mouthwash to your daily care routine can help sweeten your breath. Select alcohol-free products -- they are less drying. And, pick a mouthwash with fluoride; it can help prevent cavities by strengthening your teeth.

Happy Valentine’s Day! Brush, floss, and rinse before you pucker up!