Silent No More

By Steve Pollock

Did you catch the ABC News with Diane Sawyer this Wednesday? There was a moving story on children’s dental health.
It was part of a new ABCNews series called, “Hidden America.” ABC says this series is about the people, places and stories of struggle and hope that are not apparent to many Americans.

This first segment was about America’s “Invisible Health Crisis” -- dental disease. It is a problem most American’s probably never think about. We know it very well.

Did you know that 16 million children did not receive even the most basic preventive dental care during 2009?

Did you know that Emergency Rooms say they are treating greater numbers of toddlers whose teeth are blackened from decay and bacteria and multiple cavities?

And it is not just low income children!

Thankfully, this story is gradually gaining momentum in the mainstream media and more people are discovering the immense impact poor dental health has on our lives.  There are other equally moving articles in The New York Times, USA Today, PBS Newshour, and Consumer Reports.

If children can be seen early and regularly and receive the benefits of fluoride varnish and sealants, much of this disease could be prevented.

Silent, invisible, and hidden are three words ABC used describe this oral health crisis.  We’re working to change that.

Is Your Health Plan “Reform Ready” for Dental?

By Dennis Leonard

If you’re with a health plan, it’s a pretty sure guess you’ve spent many hundreds of hours over the past 18 months studying the Affordable Care Act to understand how it will impact your business. I know that because we’ve spent that much time and more studying the ACA’s dental mandate for children, and how it will impact our dental benefit business and the relationships we have as the third party dental administrators for our health plan clients. The ACA requires an additional 27 million children be covered by dental insurance in 2014. Many of these children are considered “high risk” and have been without dental insurance coverage and oral care. This fact will surely impact the business of health plans across the country.

What are the implications of this mandate for health plans? What are the components of dental benefits design both on the front and back end that health plans should be aware of?

We can answer these questions. Next Tuesday, April 24th, DentaQuest will host a webinar to address the oral health implications of health care reform and advise members of America’s Health Insurance Plans (AHIP), the national trade association representing the health insurance industry, how to best manage them.

The session will guide health plan executives on reevaluating whether their health plan business is reform ready for dental, and will feature our in-house experts in dental benefits administration, market intelligence, and management of clinical outcomes with higher-risk populations.

By the end of the webinar, participants will be armed with good information to guide their strategy for incorporating dental, or expanding their dental benefits offerings while meeting the requirements of the ACA’s dental mandate for children.

This free webinar is also available to the public, so please, register here!

Association? Causality? Can’t We All Work Together for Optimal Health??

By Dr. Doyle Williams, Chief Dental Officer
Dr. Linda Vidone, Dental Director and a practicing periodontist

You probably saw this in the news: The American Heart Association (AHA) issued a “scientific statement” that there is no conclusive evidence that periodontal disease causes or increases rates of cardiovascular illness. They came to this conclusion after a 3-year analysis of some 600 studies by an expert committee, led by a dentist and a cardiologist. The statement was endorsed by the American Dental Association Council on Scientific Affairs.

Wow! For decades, dentists, periodontists and researchers have been talking about a link between gum disease and heart attacks or stroke.

The AHA statement did note that “the two disorders (periodontal disease and heart disease) share a number of common risk factors, including-- cigarette smoking, age, and diabetes mellitus.”

Here’s what the American Dental Association said about this:
Although there is research showing that gum disease is associated with several other health conditions such as heart disease, stroke and diabetes, just because the two conditions are associated with each other doesn’t mean that one causes the other.

The difference is association and cause.

Here’s our take on this.
1. Both periodontal disease and cardiovascular disease are complex conditions that are influenced by multiple factors (cigarette smoking, age, and diabetes). The two diseases develop over time.
2. There is a common element to both diseases and that is inflammation.
3. Treating moderate to severe periodontal disease to the point where the clinical signs of the disease (puffiness and bleeding) are reduced also reduces indicators of inflammation in the system (like C-reactive protein, fibrinogen and white blood cells).
4. In untreated periodontal disease, certain bacteria found in pockets around diseased teeth are very similar to bacteria found in swelling in the artery wall.
5. There are studies that show if you reduce the body’s inflammatory burden, you reduce the risk of heart attack.

Cause or Association? Does it really matter?
Periodontal disease means there is unhealthy bacteria inhabiting your gum tissue. Your mouth is a gateway to the rest of your body. Doesn’t it make sense that if you control the bacteria causing inflammation in your mouth, you are healthier overall.

Be sure to point out any puffiness or bleeding in your gums to your oral health professional and your physician.

And, don’t use this study as an excuse to slack off in your home health habits. You still have to brush and floss every day.

Hispanic Oral Health

By Dr. Doyle Williams, Chief Dental Officer

A new survey presented at the Hispanic Dental Association’s annual meeting in November reveals some fascinating things about the oral health needs and wants of the fastest growing population in the United States.

The survey, released by Dr. Sarita Arteag and Dr. Ivan Lugo, both from the University of Connecticut School of Dental Medicine, asked Hispanics around the country about their oral care and what they thought would help improve it.

Some of the key findings include:

• Almost one-third of Hispanics thought cavities will go away on their own through regular tooth brushing.
  
• Among Hispanic parents, many knowledge gaps exist, as does the desire for more oral health information. Yet, eight in 10 Hispanic parents (82 percent) consider themselves an excellent or a good source for teaching their children about oral health habits. 

These findings underscore the importance of accessible, culturally-competent care and the promotion of oral health literacy, as both help prevent conditions and diseases like cavities, gingivitis and oral cancer.  It is crucial to make sure people, and especially care givers, know how to care for their teeth and gums (and their children’s teeth and gums), know the signs for concern, and when and where to go for help.

When education and culturally-competent care is accessible for parents and children alike we can ensure that everyone, regardless of language or cultural barriers, will take necessary steps toward good oral health.

X-Rays: Do the Risks Outweigh the Benefits?

By Dr. Doyle Williams

The new study released today showing a correlation between certain kinds of dental x-rays and brain tumors is causing unnecessary alarm throughout the media this morning.  The study looked at people diagnosed with intracranial meningioma, one of the most common brain tumors, compared them with a similar number of healthy people and noticed that those with the tumors were more than twice as likely to report ever having had bitewing images taken.

X-rays are a useful diagnostic tool for dentists as they work with their patients to maintain good oral health. They help your dentist more accurately diagnose cavities, monitor bone loss caused by periodontal disease, detect infections, and see how the jaw is developing in children.

A traditional X-ray (your dentist calls this a "bitewing" X-ray) involves the four corners of the mouth and emits about .005 millisieverts of radiation, according to the American College of Radiology. This is the same amount of radiation you may receive in the course of a day from the sun and is considered "negligible." During the x-ray, you are protected from unnecessary radiation exposure to other parts of the body by wearing a lead shield or apron, sometimes with a collar. Dentistry has made great advances to lower the radiation dose administered. Today, it is just tenths of seconds.

The digital X-rays that many dentists use today require even less radiation than traditional ones, making them a good choice for patients who are undergoing complicated restoration work or who want the lowest radiation possible. The average digital dental x-ray is equivalent to sitting and watching television for a few minutes.

As a patient, you do have a choice. You do not have to get an X-ray if you don't feel comfortable. However, if you are facing significant dental work, they can be useful.

The next time you visit your dentist, start a conversation about why and how often you need an X-ray. If you are concerned about safety, it is important that you to talk to your dentist about his or her philosophy on the use and frequency of x-rays.

The goal is to feel more comfortable, whichever route you decide to take.

Oral Health Literacy Workshop

Dr. Doyle Williams, Chief Dental Officer

What’s your oral health IQ?

If you read this blog, you know that

• dental disease is the most common chronic disease among children
• gum disease can be managed with good home care
• and both tooth decay and gum disease are preventable.

After reading the news this month, it seems to me that we all could use a refresher course in oral health education.

Just this week, actress Alicia Silverstone made news because she feeds her 11-month-old child by chewing food and passing it directly into his mouth from hers.  She may not know this but cavities (caries) are a bacterial infection. Babies most often get the bacteria from some form of exchange of saliva from an adult or another child in their families.

A few weeks ago, the New York Times and NBC called attention to the increase in the number of pre-school children with cavities. The Centers for Disease Control and Prevention says this is the first increase in 40 years. Across the U.S., dentists say they are seeing more young children aged five and younger, at all income levels, with six to 10 cavities or more and a level of decay requiring general anesthesia for extensive restorative work. One contributor to this rise in pre-school tooth decay is constant snacking and a relaxed attitude to brushing teeth every day.

I’ve also noted the growing trend for people to use the hospital ER as the first line of treatment for dental emergencies. These patients are paying 10 times as much and not getting the treatment that they would get from a preventive visit to the dentist.

Diabetes and Your Oral Health

By Dr. Doyle Williams, Chief Dental Officer

In recognition of its annual  Alert Day – March 27— the American Diabetes Association is encouraging everyone to take the Diabetes Risk Test to find out if they might develop type 2 diabetes.

If you can, take a few minutes to do this. There is a strong link between diabetes and gum disease.

In the United States, nearly 26 million children and adults suffer from diabetes, and a quarter of them – 7 million – don’t even know they have it.

Researchers have found that gum disease is especially prevalent in diabetics. In fact, people with diabetes are at increased risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). Diabetics are typically more vulnerable to bacterial infection and have a diminished ability to fight infection and inflammation once they invade the gums.

Gum disease can make blood sugar levels fluctuate, making it more difficult to control the disease. Diabetics are also more susceptible to other complications like bacterial infections, dry mouth and fungal infections.

These complications underscore the importance of maintaining good oral health and keeping your dentist up to date on your general health. If you have diabetes, be sure to control your blood glucose levels, and let your dentist and hygienist know of your condition so they can be ready to meet your needs.

Postpone any non-emergency dental procedures until your blood sugar levels are under control. For more information, visit http://www.diabetes.org.