Oral Health Matters

“Bombing” Away Tooth Decay

2012-02-01T06:11:00.000-08:00

By Doyle Williams, Chief Dental Officer

Tooth decay better watch out; there’s a new oral health weapon on the horizon – and it comes in liquid form.

The new (and not yet approved for release to market) “Smart bomb” mouthwash, developed by Wenyuan Shi, chair of the oral biology section of the UCLA School of Dentistry, targets S. mutans, the strain of bacteria largely responsible for tooth decay.

This smart mouthwash works by targeting only the harmful bacteria, the S. mutans, without damaging helpful bacteria. In other words, it identifies the bad guys and bombs them away while leaving the good guys to carry on with their regular job of protecting your mouth.

A “Smart Bomb” mouthwash study has been published in the November issue of the Caries Research journal. The next step is getting FDA approval. If approved, this mouthwash would be the first preventive drug developed to fight tooth decay since fluoride. I always get excited about the potential for new ways to stop tooth decay. I’ll keep watching the progress of this drug, and report back if it’s approved.

February is National Children's Dental Health Month and that means a great opportunity to remind parents and caregivers to teach their children that cavities are preventable! Coach your children to brush their teeth twice a day, and to floss daily. Encourage them to eat healthy foods and to drink beverages that are not high in sugar. And make sure they visit a dental care provider at least once a year for a check up.

Having more preventive measures against tooth decay is one of the best ways to make sure our children keep their teeth healthy.

Let’s Focus on Quality, not Quantity

2012-01-27T10:07:00.000-08:00

By Mark Doherty, DMD, Executive Director, DentaQuest Institute

It’s hard to miss the fact that our health care system is in the middle of a lot of change. I read about “pay for performance,” “accountable care organizations” and “value-based care” all the time. Oral health is not usually part of the discussion but that won’t be for long. The growing cost of care, the variation in treatments and care outcomes and the significant disparities faced by disadvantaged groups are important issues for dental care delivery too.

So I am very excited by the strong interest and motivation among my peers to find opportunities to focus on quality rather than quantity in America’s oral health care delivery system. I just returned from a meeting in Washington, D.C. with leaders in oral health and health care from across the care delivery spectrum (ADA, ADEA, CDHP, ADHA, CDC, HRSA, IHI, CMS, dental educators, providers, hospitals, health policy experts, insurers and more) where quality improvement and accountability were the central topics. Folks left the meeting ready to take part in this Quality Journey.

The impetus for the meeting was a new report (just released), edited by Paul Glassman DDS, MA, MBA, professor of dental practice and director of the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry. The report, Oral Health Quality Improvement in the Era of Accountability, is a call for a new dialogue on how to improve quality and increase access to affordable dental care.

Until now, the limited evidence of best practice for most dental procedures has led to widespread variation in clinical decisions among dentists; [Read the blog post, To Fill or Not to Fill by my colleague Dr. Doyle Williams to understand the variability in treatment approaches.] And today, there are few incentives to implement quality improvement programs.

But we need to. Dental expenses are now one of the highest out-of-pocket health costs for consumers. And 37 percent of African American children and 41 percent of Hispanic children have untreated tooth decay, compared to 25 percent of white children. The disparity is unacceptable.

Take a close look at the ideas in this report. We need to look at the opportunities to do better.

At the DentaQuest Institute, we’re emphasizing prevention and disease management in our quality improvement initiatives. The good news is that this approach works. When we apply a disease management model to the care of a chronic disease like Early Childhood Caries (ECC), we are seeing longer-term improvements in the patient’s oral health.

The DentaQuest Institute will post the presentations from the meeting in Washington on our website.

This is an exciting time for those of us who are passionate about better oral health for all.

New Year, New Design

2012-01-19T10:47:00.000-08:00

From the Oral Health Matters team

You may have noticed some changes here at Oral Health Matters. We decided to improve the blog, much like our commitment to improving oral health.

We redesigned the blog so it’s easier for you to read. You’ll notice there is more white space in the new design, and the photos of our contributors have been moved to a new column on the left to help keep them in view. Tools for sharing and searching the blog are more prominently displayed at the top of the right hand column, making it simple to share posts and search by topic.

We will continue to share our thoughts, ideas, stories and news in oral health innovations with you in 2012.

We invite you all to tweet at us to let us know what you think! If you’re not already following us on Twitter, come check us out: @dentaquest

Best,
Doyle, Fay, Steve, Ralph, & Mark

A [Dental] Wake Up Call for Baby Boomers

2012-01-10T11:10:00.000-08:00

Guest Post by Dr. Michael Monopoli, DentaQuest Foundation Director of Policy and Programs

The baby boom generation has consistently enjoyed better health and better oral health than any previous generation. Thanks to community water fluoridation, fluoride toothpastes and having dental insurance as part of employer-sponsored health plans, this generation is the first where a majority will keep and maintain their natural teeth over their entire lifetime.

This is wonderful news, and the facts support it. CDC data shows that over the past decade, the number of adults missing all their natural teeth has declined from 31 percent to 25 percent for those aged 60 years and older. And more good news: Seventy percent of adults at or above the poverty level said they visited a dentist in the past 12 months (CDC Fact Sheet). This is a generation that cares about and values its good oral health.

But there’s a serious dental wake-up call on the horizon for this first wave of boomer retirees. Even with largely good oral health, today’s retiring adults are realizing they will have to plan to pay largely out of pocket for dental care to maintain their oral health beyond their working years.

Many have all of their teeth and received routine dental care through their lives. They are now struggling with the realization that Medicare generally doesn’t cover routine dental procedures, such as cleanings or fillings. Medicaid, the jointly-funded Federal-State health insurance program for low-income people, funds dental care for low income and disabled elderly in a few states, but reimbursements are low. Most dental plans that cover the necessary services to maintain good oral health are based on employment and these dental benefits are lost with retirement. Retirees now have to figure out how they can continue the level of dental care they enjoyed through their working lives, and will need to balance these expenses along with other important needs like food, housing, and the rest.

And to add insult to injury, over the past decade, the value of retirement funds and IRAs has been shrinking with the ups and downs of the economy. Some retirees are facing the fact that their retirement funds may no longer support the lifestyle they were used to or hoped for – including good preventive health services.

It’s not a comfortable feeling to have to decide what dental care you are willing to pay for in order to have good oral health -- especially when we know good oral health is an integral part of overall health.

This is one of the issues that was discussed by the new U.S. National Oral Health Alliance, leaders from dentistry, medicine, dental education and the dental industry, health advocates, policy makers and philanthropy at their first leadership colloquium in 2011. Without access to oral health care and prevention, our nation’s most vulnerable families are at high risk. Many middle class elders will begin to face dental issues that our nation’s most vulnerable families have faced for many years. Hopefully, this larger group will change the conversation.

Best Wishes for Optimal Oral Health!

2012-01-03T06:03:00.000-08:00

Grantees of the Oral Health 2014 Initiative, the DentaQuest Foundation's multi-year campaign to strengthen and accelerate state and community action on behalf of better oral health, met as a group for the first time on November 9 and 10 in Washington, DC. Grantees, advisors and DentaQuest Foundation staff gathered for an Oral Health 2014 group photo.

Best Wishes for Happy Holiday Season and a Healthy New Year

2011-12-21T12:42:00.000-08:00

No matter what holiday you celebrate this season, we wish you good oral health.
Happy Holidays from all of us at DentaQuest.

View our video greeting here: DentaQuest Holiday

Better Care for Today; a Better Healthcare System for Tomorrow

2011-12-16T06:22:00.000-08:00

Guest blog post by Cindy Hannon, DentaQuest Institute Quality Improvement Manager

I just had an inspiring experience at the Institute for Healthcare Improvement’s (IHI) 23rd Annual Forum. Over 6,000 participants (yes 6,000!) converged on Orlando, Florida to focus on quality in healthcare. Over the last year, I have been working with DentaQuest Institute partners on three Quality Improvement projects in dental care – Dental Sealants for Adolescents, Early Childhood Caries (ECC), and Elimination of Dental Disease.

I wanted to attend this year’s IHI Forum because the DentaQuest Institute is gearing up for an exciting 2012 with a strong focus on quality and a prevention-focused, disease management model of care. There is a lot to be learned from the work of the Institute for Healthcare Improvement. Its successes are lessons in the kind of change management that facilitates improvements within a care system. Time and again, people that I met in sessions and around the conference said they were so happy to have people involved in dentistry at the quality table.

Maureen Bisognano, President and CEO of IHI started the two-day forum reminding us of our purpose -- we are capable of “making better care for today and a better healthcare system for tomorrow.”

With Quality Improvement, we are “acting for the individual but learning for the population.” Stories of patients and their families are important tools: “Stories,” Maureen reminded us “are first personal, then they become public, and then collective, and lastly, they become political.” There is a connecting thread: we help the individual and what we learn supports improvement for others. A compelling patient story helps grab attention today and builds the will for change. Our patient encounters help us understand the situation (patient, disease and environment) and devise better solutions. Data help us make the case to move change through the system. Quality improvement, at its core, is applying reliable new knowledge (science-based evidence) with a goal of better outcomes.

On the plane returning to Massachusetts, I sat in my seat tired but full of energy. Charlie Homer, MD, MPH, President of the National Initiative for Children’s Health Quality (NICHQ) and a national leader in improving the quality of healthcare for children, was on the same flight. Jane Taylor, EdD, an Improvement Advisor for IHI, was also on the flight. I was just a few rows behind them. It occurred to me –dentistry may be behind medicine in this quality improvement work, but we are all on the same flight, headed for the same destination… better health outcomes. And, I am thinking about the stories we will have to tell.

To Fill or Not to Fill: That is the Question

2011-12-06T05:27:00.000-08:00

By Dr. Doyle Williams, Chief Dental Officer, DentaQuest

Recently, the New York Times published an article, “A Closer Look at Teeth May Mean More Fillings for Dentists,” which discussed microcavities and the different ways dental care providers treat them. A 22 year old college student who had grown up without ever having a cavity visited a dentist while at college and found out she had a cavity – in fact, multiple cavities. Somehow, in just 12 months, she went from perfect oral health to having many cavities. How can that be?

Ever new technologies make it possible for dentists to find very early stage cavities (microcavities) that can’t be seen with X-rays or the naked eye. These technologies are an effective tool in identifying early decay and allowing dentists to address it before it progresses to become a bigger and more painful problem.

The microcavities they detect are abnormalities which can be an indication of the beginnings of tooth decay. For patients who previously had perfect oral health, hearing they may have a number of cavities that need to be filled is a shock. If you are concerned that a diagnosis doesn’t match up with your prior dental history (and there has been no change in your home care or health), it is never a bad idea to get a second opinion.

Today, when dental teams catch disease in an early stage, there are more options for patients than the traditional filling. For example, dentists can watch and wait to see what happens as suggested in the article by Dr. James Bader, a research professor at the University of North Carolina School of Dentistry.

Another approach is to take preventive steps. The diagnosis of a microcavity may lead a dentist to recommend the application of sealants, a thin plastic coating applied to the teeth to protect them from the bacteria that causes dental disease and the potential for further decay.

Or, a dental health professional may attempt to help “heal” the tooth. At the DentaQuest Oral Health Center, the dental team would take steps to reduce the level of the decay-causing bacteria in the patient’s mouth, and enhance the body’s natural ability to replace minerals. So instead of placing fillings that will need to be replaced in the future, they use other measures to stop early decay, help the tooth heal, and then make it more resistant to future decay. It’s a prevention-focused approach to oral health care.

My colleague, Peter Blanchard, DDS, MBA; Director, Evidence-based Practice, DentaQuest Oral Health Center, wrote an op ed in response to the New York Times article entitled “To fill or not to fill: That is the question” which was published on DrBicuspid.com.

Finding cavities early is never a bad idea. It gives us more options to help our patients stay disease free.

Recognizing “Excellent” Dental Programs

2011-11-23T08:26:00.000-08:00

By Dr. Mark Doherty, Executive Director, DentaQuest Institute

The DentaQuest Institute had the great honor of hosting the John Rossetti Memorial dinner at the 2011 National Primary Oral Health Conference. John was a personal friend and a great advisor to the DentaQuest Institute and its Safety Net Solutions program. He was one of the program’s first Expert Advisors – our elite faculty of experienced public health dentists who are mentoring safety net dental programs across the United States. It was a great privilege to host the memorial dinner and to endow our annual Centers of Excellence Awards with John’s name.

The John Rossetti Centers for Excellence awards recognize elite safety net dental programs of 2011– programs that displayed tremendous leadership and excellence in oral health practice management, greatly improving access to care and the oral health status of their patients. The recipients of this award provided the leadership and initiative necessary to make positive change “stick” within their dental programs.

The five 2011 Centers of Excellence partnered with Safety Net Solutions technical assistance and practice management consulting over the course of the past year. They were challenged to institute difficult changes with the goals of increasing access, promoting financial sustainability and improving oral health outcomes.

The five programs selected this year truly deserve the “Excellent” title – they have outstanding evaluation data to show that the changes they implemented have lead to measurable improvements in many areas of the dental program.

The 2011 Safety Net Solutions Centers of Excellence are:

We commend each of these Centers for Excellence, and thank all of the safety net dental programs for being examples of sustainable dental care in their communities. I think John Rossetti would be proud of all of them.

What you don’t know about oral health may hurt you

2011-11-15T14:50:00.000-08:00

By Dr. Doyle Williams, Chief Dental Officer

When people hear the phrase, “I’m in good health,” chances are they aren’t thinking about their mouths.

But you should. A regular check up with your dentist is as important as an annual physical. If you are someone who is afraid of the dentist and only make an appointment when you are in pain – think of this: regular preventive care is not painful and it will help prevent painful visits in the future. Good oral health serves much more than cosmetic purposes – it is integral to your overall good health.

Teeth, gums and oral soft tissue are all susceptible to a range of conditions and diseases, including cavities, gingivitis and oral cancer. The irony is that dental disease – cavities and gum disease – are nearly 100 percent preventable if you know what to do. It’s what you don’t know about oral health that may hurt you. That’s oral health literacy.

Culturally-competent oral health literacy is as important as seeing an oral health professional. For some, a painful tooth may be enough reason to schedule a visit with a dentist. But others may wait to see bleeding, swelling, or a fever before thinking about getting care.

That’s the challenge of oral health literacy – making sure people know how to care for their teeth and gums, making sure they know the signs for concern, and making sure they know when and where to go for help.

Here are two examples:

The U.S. Surgeon General stressed that parents who are unfamiliar with the importance and care of their child’s primary teeth are unlikely to take appropriate action that may prevent Early Childhood Caries (ECC). That includes food choices, bedtime bottle routines, daily oral hygiene, and failure to see a health professional as the baby teeth are starting to come in.

Recently, a 24-year old father from Cincinnati, Ohio died from a tooth infection because he could not afford his medication. When his face and mouth began to swell, the man visited the emergency room at his local hospital where he was given prescriptions for pain medication and antibiotics. Because he could not afford both medications, he only filled the prescription for the pain medication. That helped the pain but the infection continued to spread, eventually to his brain.

Knowledge is power. Everyone has a role in making sure that oral health is an integral part of their overall health.

What do you think needs to be addressed to improve America’s oral health literacy?

Oral Health is Now a Leading Health Indicator

2011-11-04T12:56:00.000-07:00

By Steve Pollock, President, DentaQuest

At the annual meeting of the American Public Health Association this week, the Department of Health and Human Services (HHS) announced three new categories of Leading Health Indicators for the Healthy People 2020 campaign. The good news is oral health has been identified as a Leading Health Indicator category…finally.

Healthy People 2020 identified 17 oral health goals -- from reducing the rate of dental caries in the primary and permanent teeth of children and adolescents – to increasing the number of children, adolescents and adults who use the oral healthcare system.

HHS named Oral Health a Leading Health Indicator because it is a critical health issue that, if left unaddressed, could result in future public health problems. DentaQuest could not agree more.

Everything we do is focused on our singular mission to improve oral health. Our Preventistry^SM philosophy ensures a unique focus on prevention, disease management, quality care, and cost effective benefit program administration, and recognizes and supports the important provider-patient relationship in achieving good oral health. Our DentaQuest Institute isolates areas where we know there is a better way to prevent and manage oral disease, and works to make new and proven dental therapies routinely available in the dental office. Historically, new evidence-based care learnings take years to become accepted and practiced in the dental office setting, and the Institute is working to change that. Our DentaQuest Foundation is driving a grassroots movement across the nation to improve oral health with its Oral Health 2014 Initiative, awarding 20 state organizations funding and resources to reduce oral health disparities, one of the biggest cost drivers in the American health care system.

We are committed to our mission and intent on setting goals and measuring our success against them. We’re working on that. But with Healthy People 2020’s designation of oral health as a Leading Health Indicator, our ability to affect our mission takes a major step forward. With the endorsement of HHS and the power of Healthy People 2020 focused on oral health improvement, much will be done to prevent oral disease. Our population will be healthier and our state and national health care systems will see costs go down. Without good oral health, it’s impossible to enjoy good overall health.

Oral diseases are almost 100% preventable. With the right focus and resources, oral disease is one chronic health problem that we can target and eliminate – in our lifetime. I am convinced that with a coordinated system of collaboration and persistence, oral diseases can become a thing of the past.

Building a Movement for Optimal Oral Health

2011-10-28T08:50:00.000-07:00

By Ralph Fuccillo, President, DentaQuest Foundation

According to a recent report from the Institute of Medicine, “Millions of Americans are not receiving needed dental care services because of "persistent and systemic" barriers that limit their access to oral health care. Nearly 5 million children went without regular dental checkups in 2008 because of financial limitations. 33.3 million Americans live in an area with a shortage of dental professionals.” Improving Access to Oral Health Care for Vulnerable and Underserved Populations

Stories like this illustrate the need that drives the DentaQuest Foundation’s investments in oral health improvement at the national, state and local levels. Previously, I wrote about the DentaQuest Foundation’s support for the U.S. National Oral Health Alliance which is engaging national partners in oral health improvement goals.

People feel the pain of their inability to get needed services at the local level. So today, I am writing about the Oral Health 2014 Initiative. This new signature program of the DentaQuest Foundation is building a movement for oral health at the state and community level by supporting the work of state-based organizations that are developing effective community solutions.

When we announced the Oral Health 2014 initiative, we immediately saw a clear need and interest in community solutions for oral health across the United States. Over 200 program leaders from nearly every state joined in our Request for Proposals launch webinar in June. Seventy (70) organizations responded with their ideas. Thirty-six (36) were invited to submit a full proposal.

Today, Oral Health 2014 is taking root and moving forward in 20 states. I am enthusiastic about every one of these organizations. Each is working to build support for oral health solutions in their communities, engaging traditional and not-so-traditional partners. Oral Health 2014 is a multi-year initiative. The DentaQuest Foundation is committed to each organization’s success, providing financial and technical resources to help them move their projects forward.

This is an important moment for oral health. These 20 state organizations join the growing national movement of collaborative leaders who are aligned in their desire to address oral health disparities-- many hands working toward a common goal.

I extend the gratitude of the DentaQuest Foundation to the National Advisory Committee of leaders in community health, philanthropy, civic engagement, and members of the founding board of the U.S. National Oral Health Alliance. They provided guidance in the development of the program and the selection of grantees.

Dr. Caswell Evans of the University of Illinois, DentaQuest Foundation Board of Directors and the U.S. National Oral Health Alliance Founding Board of Directors
Paul Gilmer of Triana Energy and a member of the National Community Committee of the CDC Prevention Research Centers
Dr. Leslie E. Grant of the National Dental Association and the U.S. National Oral Health Alliance Founding Board of Directors
Marion Kane, formerly of Barr Foundation and currently on the Board of the Directors for the DentaQuest Foundation
Dr. Dushanka Kleinman of the University of Maryland School of Public Health and the U.S. National Oral Health Alliance Founding Board of Directors
Barbara Leonard of the Maine Health Access Foundation
Sandra Owens Lawson of CRP Corp.
Dr. Lindsey Robinson of the California Dental Association Foundation and the U.S. National Oral Health Alliance Founding Board of Directors, and
Dr. Donna Shelley of New York University School of Nursing and Dentistry.

Congratulations to our new Oral Health 2014 partners! I encourage you to join them in building collaborative solutions.

The DentaQuest Foundation will continue to look for ways to support local leaders in their important work to make oral health a public health priority. We encourage every group who was interested in Oral Health 2014 to stay active as oral health advocates by contributing their talents and enthusiasm to the work of the U.S. National Oral Health Alliance which is tackling the same priority areas at the national level.

Within Dr. King’s Dream…..

2011-10-12T13:38:00.000-07:00

Ralph Fuccillo, President, DentaQuest Foundation

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Martin Luther King Jr., 1966.

When the Martin Luther King, Jr. Memorial is dedicated in Washington, D.C. this October 16^th, America will celebrate the inclusive and powerful legacy that constituted Dr. King’s overall dream for justice. This occasion has prompted me to reflect on opportunities to add a voice to this national moment of hope that keeps Dr. King’s dream alive.

Within all the memorable words of Dr. King, those spoken on the subject of health care and inequality resound in my mind most strongly. Throughout a career dedicated to prevention and public health, I have come upon too many situations where life’s odds are stacked against those in greatest need and people who are dealing with chronic illness in our communities. When I think that we have not solved “the most shocking and inhumane forms of inequality” in the 45 years since Dr. King made this claim, I know that our work is nowhere near completed.

We are moving forward with tremendous opportunities in the era of health care reform and when the value of collaboration is being recognized as a powerful method for better decision making in many sectors. I have witnessed many examples of how changes in the conditions in which people live are making a tremendous difference in reducing inequalities. These include investments to increase access to healthy fresh foods, investments in safe places to exercise and play, and investments in community supports to navigate options for health care.

The occasion to memorialize Dr. King’s legacy is an excellent one to promote effective leadership across all sectors-- business, government and philanthropy -- to create pathways for health equity. A new program of the United States Department of Health and Human Services (HHS) encourages such collaboration. The National Partnership for Action (NPA) to End Health Disparities provides opportunities to engage in Health Equity Councils in all ten regions across the United States. Each council is engaging community-based leader across health, business, philanthropy and community to move the dial on health equity through better collaboration among stakeholders and more effective use of public and private resources to reduce racial and ethnic health disparities.

No one sector can create the conditions for better health alone. It takes a cohesive and inclusive national strategy that leverages layers of public and private sector investments and creates critical partnerships. I am honored to represent oral health and philanthropy on the Region I Health Equity Council and invite others to learn more about the Councils and to get involved.

The dedication of the Martin Luther King, Jr. Memorial this month reminds our nation of its commitment to ensuring equality for all. For me it is an opportunity to highlight the important efforts of the many people and organizations working for equal access to quality health care.

Today is Child Health Day!

2011-10-03T13:54:00.000-07:00

By Dr. Doyle Williams

Did you know that tooth decay is the most common childhood disease?

That cavities are almost 100 percent preventable when children have access to prevention, education and treatment services.

That 1/3^rd of children ages 6 to 8 have untreated caries (cavity) in a permanent tooth.

That every year, 16 million children go without dental care, placing them at great risk of getting cavities or worse.

Today, on Child Health Day I would like to remind you how important your child’s dental health is to his/her wellbeing.

Please take a moment to sit down with your child today to talk about the importance of good oral health in their lives and what they can do to help keep a healthy smile.

Sign of the Times: Tough Economy Shows in Dental Visits

2011-09-30T12:59:00.000-07:00

Dr. Doyle Williams, Chief Dental Officer, DentaQuest

A public opinion survey* by Oral Health America confirmed a trend that I’ve been hearing about lately as I talk to dentists across the United States.

The survey revealed that one-third (35 percent) of people who regularly visit the dentist are going less frequently. One-half (47 percent) of larger households and households with children reduced their visits to the dentist in the past year. Families with younger children cut back more than households with slightly older children.

Regrettably, preventive dental care appears to be something that is falling through the cracks, when families are faced with managing competing needs in a challenging economy.

And that concerns me.

Dental care is the #1 unmet health care need for children and low-income adults. Cavities and gum disease are preventable. Regular dental visits are investments in long term good health. With regular visits, it is more likely that problems can be found early when dentists can help teeth “heal” without any drilling. Your oral health caregiver can show you how to protect yourself and your children from getting cavities and gum disease by helping you understand your risk factors and protective factors. You may also be told about preventive treatments, like sealants, a thin protective coating painted on the molars of the teeth of children and adolescents, to protect against cavities.

Cavities and gum disease are bacterial infections. Studies show links between gum disease and premature births, diabetes, respiratory disease, and cardiovascular disease. I was recently very saddened to read about the young father in Ohio who died from an infection that started in a wisdom tooth and spread to his brain.

Not going to the dentist means you don’t get early warning of problems or important preventive education and information to keep you from needing costly treatments later.

*Oral Health America public opinion survey sponsored by Oral Healthcare Can’t Wait and Plackers

Make This a Fall for Smiles!

2011-09-21T13:06:00.000-07:00

By Steve Pollock, President, DentaQuest

Good dental health starts at home, and parents and caregivers are THE most important role models for their children. Oral Health America has a nice booklet, Fall for Smiles, on their website that can help families talk about good oral health. Also, from September 19-25, Trident gum is donating 5 cents to Smiles Across America® for every pack of Trident gum sold. Smiles Across America helps children who do not get regular dental visits because their families lack resources, insurance, transportation, or because of language barriers.

Make this a fall for Smiles! Brush and floss your teeth daily. Be careful about the sugars in your diet. Avoid tobacco products. And schedule a visit with your dentist.

Bananas about MOM

2011-09-09T12:00:00.000-07:00

By Felix Layne, Vice President Finance, DentaQuest

From left to right: Pat Finnerty, DentaQuest Foundation; Bridget Hengle, DentaQuest; Felix Layne, DentaQuest; Cheryl Harris, DentaQuest; Debborah Oswalt, Virginia Health Care Foundation (ED); Waradah Eargle, DentaQuest.

Bananas and oral health? You bet they’re connected!

First let me give you some context for this story. Over 425 volunteers from Virginia and 12 states traveled to rural Western Virginia this summer to make the Wise County Mission of Mercy (MOM), sponsored by the Virginia Dental Association Foundation, and the delivery of free dental care to underserved people possible. Volunteers were dentists and hygienists as well as those not directly involved in delivering care, like me—I work in the finance department of DentaQuest.

This was my second Wise County MOM experience, and last year my role was dental hygienist assistant. This year, I was a member of the DentaQuest Virginia team responsible for distributing snacks and beverages to help sustain the hard working volunteers. This year, a dentist came to the DentaQuest snack trailer asking for a banana because his hand was cramping. The dental teams work in extremely hot tents starting at 5:30 am and continue late into the night—so one would expect hand cramping! What helps a cramping hand? The potassium found in bananas, and we didn’t have any.

I looked at the dentist and at the lines of people waiting for care and knew there was only one thing to do. Get bananas! At the nearest supermarket, I bought the entire supply of bananas -- 4 cases totaling 160lbs. There wasn’t a single banana left by the end of the day. Next year, we’ll be purchasing 500lbs of bananas for our food service effort during this three-day event.

This Missions of Mercy effort is all great work. Over three hot July days at the Wise County Fairgrounds, 1,382 patients received dental care valued at $1.5 million. This is dental care that these individuals and families—many of whom are the working poor—wouldn’t normally be able to afford. Wise County is part of the expansive and impoverished rural Appalachian Mountain area. Folks living around here are the working poor, elderly, disabled, or uninsured. When you are struggling to get food on the table, finding money to pay for dental care isn’t realistic. For this reason, the most common procedure was not cleanings or fillings, but extractions. The majority of teeth dentists saw were beyond repair. 3,575 extractions were performed.

Efforts like Missions of Mercy bring out the best in people. The desire to make a difference was contagious and didn’t stop at bananas. All kinds of folks showed up with something to offer, from food to clothes to dental services. My 14-year old daughter came with me and had the great idea to bring 150 dolls, hand-made by and donated from the North Andover Senior Center, to give to waiting children. I was so proud of her, and grateful for the opportunity to expose her to this valuable experience.

The Wise County MOM event left a dramatic impression of the unmet need for health care services. It reaffirmed the importance of having access to insured dental care, and highlighted the many different ways there are to help people.

The Virginia Dental Health Foundation started the Wise County Missions of Mercy (MOM) eleven years ago to "make caring visible." I encourage readers of this blog to get involved -- donate time, money, your voice, or your skills to help people receive vital dental care in your community. There are Missions of Mercy projects in nearly every state throughout the year.

I’m pleased to have had the opportunity to contribute in some small way to this effort. You could say that I’m bananas about MOM events. If you are interested in participating in next year’s Wise County MOM, you can find details on volunteering here.

Our Community Health Champion!

2011-08-29T11:23:00.000-07:00

The Boston Business Journal honored Dr. Mark Doherty, Executive Director of the DentaQuest Institute as a 2011 Health Care Champion for his work in expanding the reach of oral health care throughout Massachusett at the 2011 Champions in Health Care breakfast on August 26th.

Dr. Doherty has dedicated his career to expanding access to oral health services for low-income, underinsured and uninsured individuals in Massachusetts and across the country. During a long and illustrious career, Dr. Mark Doherty has been more than a dentist. He has also played the role of businessman, problem solver, oral health advocate, and mentor to other dentists who share his passion for improving the lives of underserved individuals.

When Dr. Doherty speaks about oral health, everyone listens, including lawmakers on Beacon Hill and Capitol Hill and federal agencies overseeing community health centers across the United States. Today, Dr. Doherty is working to create partnerships with community health center dental programs and training volunteer dentists who will mentor and coach community health center dental practice staff as they implement improvements to their practices.

Among many honors, Dr. Doherty was selected the 2011 Best Practice Management Consultant by Dr. Bicuspid readers who are dental professionals.

Make oral health a part of the conversation

2011-08-24T08:00:00.000-07:00

By Ralph Fuccillo, President, DentaQuest Foundation

In today’s rocky economic climate, community health centers (CHCs) across the country have become the primary source of medical and dental health care for millions of people. In fact, many refer to CHCs as “America’s health safety net.”

Earlier this month, the US Department of Health and Human Services (HHS) announced awards of $28.8 million to 67 community health center programs across the country. These funds, made available by the Affordable Care Act, will help establish new health service delivery sites to care for an additional 286,000 patients.

As I stated in my last entry, CHCs provide primary health care services to 23 million individuals, most with limited financial resources; however, not all CHCs have the capacity to provide dental care. To give you a sense of the issue: more than 12 million CHC patients do not have access to dental care services.

DentaQuest Foundation has responded to this challenge with the Strengthening the Oral Health Safety Net Initiative, a $1.75 million investment to strengthen oral health delivery at CHCs across America.

But our investment alone is not enough. According to a recent statement from the American Dental Association (ADA), significant progress with the dental safety net will not occur until the nation places greater emphasis on oral health. We at the DentaQuest Foundation agree. Oral health must be part of the conversation, both at the individual, local community, and government levels.

As the ADA says, “Silence is the enemy. Let’s take the ‘silent’ out of ‘silent epidemic.’”

Strengthening the Oral Health Safety Net

2011-08-17T07:02:00.000-07:00

By Ralph Fuccillo, President, DentaQuest Foundation

When healthcare reform goes into effect in 2014, nearly every child in the United States will have access to dental benefits coverage, through Medicaid expansion and state exchanges, many for the first time. That is an impressive goal.

But it made us wonder how will the existing oral health care delivery system handle this dramatic volume of new individuals seeking care?

One likely source for care will be America’s health safety net of community health centers. Today, 1,250 Community Health Centers in more than 8,000 communities in 50 states and all U.S. territories provide primary health care services to 23 million individuals, most with limited financial resources. Today, not all CHCs have the capacity to provide dental care. In fact, 12 million+ community health center patients do not have access to dental care services.

Our response to this challenge is the Strengthening the Oral Health Safety Net Initiative, a $1.75 million investment to strengthen oral health delivery at community health centers across America. This Initiative is providing oral health leadership development and technical assistance to community health centers at the national, state and local levels in three ways:

1) Through a targeted investment, we are partnering with the National Association of Community Health Centers (NACHC) to build oral health leadership throughout America’s network of Federally Qualified Health Centers (FQHCs). NACHC supports its member Primary Care Associations (PCA) and their community health centers with research-based advocacy, training for health center and PCA leadership and boards, and partnerships with key stakeholders to foster the delivery of primary health care services to communities in need. NACHC will now include oral health as part of its education and advocacy work.

2) Through a very competitive Request for Proposal process, the DentaQuest Foundation invested in five state PCAs for the Strengthening the Oral Health Safety Net Initiative. Each PCA will receive funding for oral health technical assistance and leadership development to support the expansion of oral health at their member community health centers. PCAs are the state-based trade associations of health safety net organizations. They are an important partner because they provide training and continuing education, advocacy, and many other services for their member health centers.

3) Finally, up to 5 community health centers in each participating state PCA will receive direct practice improvement technical assistance to either start a new oral health program or strengthen an existing program, provided (in-kind) by the DentaQuest Institute and its Safety Net Solutions team.

We are very pleased to be working with these five PCAs in the Strengthening the Oral Health Safety Net Initiative.

Their work will become a model for PCAs in other states.

Remembering John Rossetti, Advisor, Colleague and Friend

2011-08-12T11:07:00.000-07:00

Dr. Mark Doherty, Executive Director, DentaQuest Institute

This week, we lost a good friend and oral health champion with the passing of Dr. John Rossetti. John’s life was dedicated to public service and improving the lives of others. He got his first taste of community-level engagement working in rural health in Central America as one of the first “class” of Peace Corps volunteers. After graduating from dental school, he joined the U.S. Air Force and served as a Dental Officer in New Mexico and Thailand, providing dental care in the villages surrounding his base. From there, his commitment to public service lead him to join the Indian Health Service, where as the only dentist for two reservations, he learned valuable lessons in prevention, education, early intervention and restorative services. He passed these lessons along to so many peers and public health professionals throughout the years, and his guidance and tutelage made us better at what we do.

As Chief Dental Officer for the Health Resources and Services Administration, John initiated the first ever partnership between a health agency and Medicaid to address access to oral health services for children. And after ‘retiring’ in 2002, he started a new career as a consultant. It was in 2008 that I had the privilege of welcoming John as one of the DentaQuest Institute’s Safety Net Solutions program’s first Expert Advisors – our elite faculty of experienced public health dentists who are mentoring safety net dental programs across the United States.

Mentoring was in John’s soul. He loved interacting with people and connecting the dots. But more than that, he connected pulses -- helping friends share resources and ultimately have more impact both on the profession and on each other. He made us more effective and he taught us to do it with a smile. John was a genuine Pied Piper. Was there anybody more suited to the dental profession? I cannot imagine what his chair side demeanor must have been like!

John was also the ultimate diplomat. He would warn us -- not about people –always about situations to avoid or at least to consider avoiding before blundering ahead. And, when faced with thorny decisions, John always left us a gap through which we could make a graceful exit if we were not able to go where John wished. John loved to navigate or help navigate the tough situation. I actually believe he preferred the help navigate scenario because he so valued the personal relationship part of the journey. Somewhere, he learned that he could accomplish more of his mission by sharing what he had learned with us. Lucky us!

The last time I talked to John he was very sick. He refused to talk about himself and only wanted to know about me and whether I had followed-up on something he had told me I should do. And, as expected, the follow-up was related to friends. What a guy, so unselfish! Another lesson learned.

It has been an honor and privilege to share a part of this nice man’s life. Jeez! I miss John…. All of us at the DentaQuest Institute will.

We’ve Got to Start Talking About Oral Health

2011-07-27T08:49:00.000-07:00

By Fay Donohue, CEO, DentaQuest

Here’s how we know we’ve got a problem in this country when it comes to discussing oral health: A major network morning show airs a 10-minute segment with tips on how to brush your pet’s teeth.

When was the last time you can remember a TV segment with tips on how children should brush or floss their teeth – or advice on preventive measures such as sealants? It’s probably been awhile because the most common reaction from the media when the suggestion is made is: “We don’t cover dental.”

Can that really be the case in 2011, a decade after the U.S. Surgeon General declared childhood tooth decay a “silent epidemic”? Tooth decay—which is almost 100 percent preventable—is the most prevalent chronic disease in children 5 to 17 and is growing among very young children, particularly poor young children. And poor oral health is associated with severe problems such as diabetes and heart disease, so why isn’t the media talking more about oral health?

There’s a trivialization of oral health that is baffling. Maybe with all the coverage of celebrities and the fascination with teeth whitening, there is a sense that all the talk about oral health is really just cosmetic. Nothing could be further from the truth.
Congress gets it. The Affordable Care Act ensures that dental care for children is fully integrated into the law as part of the essential benefits package for children. As we move forward with health reform, it is important to remember that oral health is a critical component of the Act and should be funded and supported.

The Centers for Medicaid and Medicare gets it. The agency established new goals to increase access to dental coverage and work with states to develop an oral health action plan for 2020.

The Institute of Medicine (IOM) gets it. IOM just released a report assessing the efforts of the Department of Health and Human Services and recommending ways of enhancing and improving oral health in America and called it “The New Oral Health Initiative.”
The Pew Center on the States gets it too. Together with the Kellogg and DentaQuest Foundations, they have put out a state-by-state score card on how states are doing in providing access to oral health for their residents. This report serves another important purpose – it gets people talking about oral health—and that’s important.

What will it take to recognize that talking about oral health is a necessary first step --- for the wellbeing of children because we can help them avoid a lifetime of tooth decay and pain, but also for the health and economic wellbeing of us all? Ignoring it shouldn’t be an option.

Related posts:
· The State of Oral Health in America is Not so Good
· Washington’s Unseen Oral Health Debate
· Some Good News at Massachusetts’ Medicaid Dental Program
· The Silent Epidemic: Early Childhood Caries

Venture Fund for Oral Health

2011-07-22T10:17:00.000-07:00

By Ralph Fuccillo, President of the DentaQuest Foundation

I’m excited to announce that we’ve launched the first-ever Venture Fund for Oral Health.

One of the major obstacles to achieving nationwide optimal oral health is the lack of funding to bring effective solutions to scale. Developed by the DentaQuest Foundation, The Venture Fund for Oral Health is a new funding opportunity for oral health programs that have shown positive outcomes and have potential to make a large-scale impact.

The four areas that the Venture’s grants focus on include:

Public policy that supports improved oral health

Increased public and private funding for oral health initiatives

Improvement in the delivery of oral health care and prevention programs

Expanded community engagement on oral health issues

To qualify for funding, organizations must demonstrate proven past successes in one of the systems that we seek to impact – policy, funding, care, community – and a well-developed plan for expansion.

By replicating programs that have proven to be successful in reducing oral health disparities, we can improve access to oral health care and reduce oral disease for vulnerable children and their families. Knowing that tooth decay is the most prevalent chronic disease among children aged five to 17, it goes without saying that the Venture Fund for Oral Health is both critical and hopeful.

So please, spread the word! If you are part of an organization that promotes oral health or know of an organization that is eligible, encourage them to apply for one of these grants.

An Alliance: Common Ground & Shared Solutions

2011-07-18T08:21:00.000-07:00

By Ralph Fuccillo
President, DentaQuest Foundation

During the past few years, I’ve had the opportunity to be part of an exciting, collaborative initiative that has mobilized the oral health community across the nation. What’s the initiative? The U.S. National Oral Health Alliance. The Alliance is bringing together groups with various interests and perspectives in a never-before-seen way. It is really quite remarkable.

The roots of the Alliance date back to the 2009 American Dental Association’s Access to Dental Care Summit, where more than 140 leaders in dentistry, dental education and the dental industry, as well as medical professionals, health advocates, opinion leaders, program heads, policy makers and others collectively addressed a common vision: ensuring access to care and prevention that supports optimal oral health for America’s most vulnerable children and adults...within the next five years.

With that vision came a commitment to work together to find common ground and work for shared solutions – and the Alliance was born. So far, we’ve made tremendous progress toward extending the common ground that grew from the Summit, but there is still more to be done. As the recent Institute of Medicine report points out, not enough Americans have access to dental care and nearly one-third of the population reports challenges in accessing dental care.

The Alliance continues to work toward a common purpose of improving access and oral health and welcomes all as partners.

Skeptics may say this is not possible, but having experienced the trust building and commitment of colleagues that built this new organization over the past two years, I am convinced we can fulfill the vision that many of you claimed as your own.

Visit www.usnoha.org. The first gathering, a Colloquium, is in November. Get your name on the list by joining the Alliance. Shared leadership, open minds, and the willingness to collaborate will further build on the best ideas to improve oral health for those who are most in need.

Related Posts:

The Oral Health 2014 Initiative

Sonrie!

Maryland Dental Action Coalition Launches 5-Year Oral Health Plan

Report from the Field: National Oral Health Conference, 2011

Tooth protection: Sealants for better oral health

2011-07-08T11:05:00.000-07:00

We in the oral health community often take it for granted that everyone understands the importance of preventive treatments when it comes to good oral health. But the reality is that everyone isn’t aware of simple, cost effective things they can do—like brushing and flossing every day and seeing your dental care provider every year. And sometimes we don’t fully appreciate how difficult it may be for some to get dental services -- and that limits their use of preventive treatments.

Prevention is important for everyone, but especially so for children. If we can keep children free from dental disease, we are giving them a strong start to a healthy life. As I’ve said here before, it is hard to do well in school or in life, when you have constant tooth pain.

Dental sealants are a very good way to prevent tooth decay in children.

For those who may not be familiar with them, dental sealants are thin plastic coatings applied to permanent molars. The sealant is applied as a liquid that is brushed onto the deep grooves of teeth by your oral healthcare professional. Sealants dry into the plastic film that provides a physical barrier to bacteria and sugar and effectively protects the pits and grooves on the biting surfaces of teeth from dental decay.

Sealants are considered a cost-effective intervention to prevent tooth decay. Consider this: the cost of applying one dental sealant is significantly less than the average cost of filling that same tooth. And when you think that a single sealant may prevent that tooth from being re-filled many times over a lifetime, it is just pennies spent for every dollar saved.

In support of sealants as a proven preventive treatment, the U.S. Department of Health and Human Services’ Healthy People 2020 set a goal of increasing the number of children who have received dental sealants on their molar teeth to 50 percent. But, despite numerous studies confirming that sealants are a cost-effective intervention, only a handful of states have reached this goal.

To help reach this national goal, the DentaQuest Institute is working with five community health center dental programs to find effective ways to increase the use of sealants for children aged 6 to 8 and adolescents 12 to 14. Those are the ages when the permanent molars erupt into the mouth. We hope the results of this Dental Sealants Initiative will help other oral health care providers make sure sealants are a standard tool in their offices for preventing cavities in children and adolescents.

We are optimistic the results of this DentaQuest Institute quality improvement initiative will increase the number of children who receive dental sealants. And that means less dental disease.

The Oral Health 2014 Initiative

2011-06-29T11:58:00.000-07:00

By Ralph Fuccillo, President, DentaQuest Foundation

On June 29, the DentaQuest Foundation launched the Oral Health 2014 initiative and opened the RFP. This is the biggest investment to date by the DentaQuest Foundation-- a multi-year commitment to strengthen and accelerate state, regional, and community action on behalf of better oral health. You can view the RFP on our website: www.dentaquestfoundation.org.

Our mission is to support and promote optimal oral health. To do that, we are directing our leadership and investments to oral health improvement at the national, state and local levels. These investments are strategic, multi-layered, and focused on improving systems– that is the systems that provide and finance care, enhance public policy, and help communities build and navigate available resources for better oral health.

Our Oral Health 2014 initiative supports that strategy. We are encouraging applicants to think outside-of-the-box, to engage a broad range of stakeholders – expected and unexpected, and to lead them in effectively developing a plan for change. We will be watching for the local impact of Oral Health 2014 grantee activities on the essential systems of Policy, Funding, Care, and Community throughout the life of the initiative.

The Oral Health 2014 initiative complements and supports the newly formed U.S. National Oral Health Alliance (Alliance) with engaged local partners across the United States. The DentaQuest Foundation is excited by the opportunities created by this Alliance to encourage cross-sector collaboration and involve many partners in solutions that meet the oral health needs of underserved children and adults in our communities. The Oral Health 2014 Initiative supports this work.

For more information about Oral Health 2014 and eligibility, contact Patrick Finnerty, Senior Advisor, State Oral Health Programs, pat.finnerty@dentaquestfoundation.org

For more information on the application process, contact Brenda Lavasta, Programs and Grants Associate, 617.886.1760, brenda.lavasta@dentaquestfoundation.org

Important Dates and Deadlines

• July 7, 2011 Informational conference call Q&A for potential applicants. Email Brenda Lavasta to join.
• July 22, 2011 (3 p.m. EST) Deadline for receipt of Letters of Intent (LOI).
• August 10, 2011 Applicants notified if invited to submit a full proposal for Planning Phase.
• September 9, 2011 (3 p.m. EST) Deadline for proposals for Planning Grant.
• October 14, 2011 Applicants notified of award decisions for Planning Grant.
• November 9-10, 2011 Grantee Gathering.

Prevention is Key

2011-06-27T11:48:00.000-07:00

It was great to see the National Prevention Council’s recently released action plan for health prevention – but I couldn’t help but notice that there was no mention of the importance of oral health—at all.

Prevention is what helps us have good oral health vs. poor oral health. And prevention is all about understanding your risk factors and protective factors. This is true if you are a child or an adult.

In this Oral Health Matters blog, I try to get my readers to think about the risk factors—the things in your life which contribute to poor oral health. There are protective factors too and I’ll talk about them in another blog post. Right now, however, I’ll highlight some common risk areas. I hope you will read through them thoughtfully. If you say ‘yes’ to any of them, it is time to make an appointment with your dentist.

Common risk areas:

Not brushing and flossing your teeth every day – to remove food and bacteria. Making this part of your daily routine is a small change that pays big benefits.

Irregular visits to the dentist. I encourage visiting your dentist at least once a year. Why? Your dentist can detect early signs of trouble and help you get on track.

Have you had a cavity within the last 3 years? Have you lost teeth because of tooth decay or gum disease? Do you have puffy or bleeding gums, receding (shrinking) gums, or areas of the gum line where the root surface of the tooth is exposed? This could mean there may be active gum disease in your mouth. Your dental professional will want to watch you closely for this.

How is your health? Are you pregnant? Have you been diagnosed with diabetes? Do you use/abuse tobacco (cigarettes, pipes, cigars, chewing) or drugs? Do you regularly take prescription/over-the counter-medicines? Do you have braces or partial dentures? Are you undergoing chemotherapy or radiation therapy? Do you have an eating disorder? Do you have dry mouth? Each of these conditions puts you at higher risk for tooth decay or gum disease. Your oral health professional will help you make adjustments to keep your mouth healthy.

Are you a between-meal-snacker? Do you have a fondness for sugary foods? Do you drink a lot of soda or energy drinks? The sugars and acids in these foods/drinks can encourage tooth decay—especially if you let them linger in your mouth for hours. Again, your oral health professional can help you understand how to lower your risk of oral disease with things as simple as rinsing your mouth with water after eating to keep your teeth healthy.

Think about your answers to these questions and use them to start a conversation with your dentist about managing your areas of risk.

I would like to see Americans get smarter about the role of oral health in their overall health. That’s why I write this blog. When consumers have the knowledge to prevent problems and know when to seek care, they will likely be healthier. That’s why it is upsetting to me that oral health was missing from the National Prevention Council’s action plan.

I’d like to hear what you have to say on the importance of prevention. What does prevention mean to you?

Related Posts:

Sonrie!

2011-06-16T12:09:00.000-07:00

Oral care in the United States is undergoing many significant changes. One of these is the exciting growth in the number of Hispanic dental practitioners and patients.

I just returned from the Hispanic Dental Association’s Annual (HDA) Roundtable in Plano, TX where I had the privilege of representing DentaQuest. HDA is a rapidly growing organization and the growth is expected to continue well into the 21st century. That’s a good thing because some experts are projecting a U.S. population that will soon be 40% Hispanic. Being able to talk to patients in a way that respects their culture and background is so important in providing the right care, at the right time, so we make a real impact.

The Hispanic Dental Association is playing a major role in building leadership for Hispanic oral health professionals during this time of change and it, like DentaQuest, is focused on prevention, treatment and education. DentaQuest and the DentaQuest Foundation are proud to support their work in improving oral health in the Hispanic population.

It was good to hear about the plans, concerns, needs and passion for dentistry among the member dentists. Several chapter presidents are DentaQuest providers. For me, this was an opportunity to explain the many facets of the DentaQuest enterprise’s commitment to improving oral health – our benefit programs, philanthropy, and clinical care improvement projects. I talked about the work we are doing to support dentists and their patients, to make participating in our networks easier, and to make sure oral health providers can deliver the best care outcomes. The dentists at the Roundtable were very interested in DentaQuest’s dental home project, our broken appointment project, and the many ways our website makes their work easier.

The dentists I met are enthusiastic champions for good oral health. They are hopeful that we will continue to support their meetings with our presence and are anxious to work with the DentaQuest Institute to improve cultural competency at the practice level. I believe that we have a very effective partnership developing. But for any effort like this to truly be successful we will need the partnership to extend to patients as well. Patients can and should play an important role. I’d like to hear from you on your thoughts.

Sip Safely

2011-06-10T09:21:00.000-07:00

Spring and summer are a time of sports and hot, humid weather which leads to very thirsty kids. That often translates into an increase in the consumption of sugary and acidic sports drinks. These seemingly harmless liquids can actually wreak havoc on children’s 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.

Frequent consumption of sports drinks lowers the pH in the mouth promoting the demineralization of tooth enamel. (The lower the pH, the more acidic the item.) Demineralization is caused primarily by stable acids found in acidic foods and drinks or which form as by product from bacteria feeding on starches and sugars in the mouth, especially refined sugars.

Demineralization begins at a pH level of 5.5 although under certain conditions, may even start at a higher pH. Popular sports drinks can have a pH of 2.4 and contain 5.5 tsp of sugar in a 12 oz can. So, not only does the drink have a pH that promotes demineralization, it also contains 5.5 tsp of sugar, which can independently contribute to demineralization and tooth decay.

To put the sports drink pH of 2.4 in perspective, compare it to battery acid, which has a pH of 0 and water, which has a pH of 5-7 (neutral). Shocking that a sports drink is closer on the pH scale to battery acid, than water.

Given all this, water is always the best option for everyone but the highest performing athletes who need to replenish minerals from intensive workouts.

If these facts haven’t convinced you to avoid the casual consumption of sports drinks, here are a few tips to keep in mind:

Don’t sip the drink throughout the day. - Drinking them for short periods of time means less time for the sugars and acids to erode enamel. Rinse your mouth with water when you’re done to clear away remaining acids and sugars.

Don’t swish the drink around your mouth. - That only increases the risk of erosion. Instead, 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 preventable with proper care. Your dentist can identify early signs of erosion, pinpoint the causes, and advise you on how to prevent further damage and more serious problems from occurring.

State of Oral Health in America is Not So Good

2011-06-01T06:31:00.000-07:00

In April, the Institute of Medicine (IOM) released a report on the state of oral health in America, concluding a two year evaluation of the current oral health care system. The U.S. Department of Health and Human Services (HHS) requested and funded this report to inform its work in addressing oral health challenges across America. HHS asked the IOM to assess the current oral health system and make strategic recommendations for its future programming. HHS is the federal agency which directs many of the government’s dental delivery, research, training and other programs.

Here are highlights:

Tooth decay continues to be a common chronic disease in the United States

The prevalence of oral diseases pose a significant burden on the health and well-being of the American people

Evidence shows that decay and other oral health complications may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes

Tooth decay is a highly preventable disease

The general public and many healthcare professionals remain unaware of oral disease risk factors and preventive approaches and they do not fully appreciate how oral health affects overall health and well-being.

The IOM recommended that HHS design an oral health initiative that addresses areas in greatest need of attention, using approaches that have the most potential for creating improvement s, and to support this effort with strong leadership, sustained interest, and the involvement of multiple stakeholders.

“The Committee on an Oral Health Initiative reaffirms that oral health is an integral part of overall health and points to many opportunities to improve the nation’s oral health,” IOM President Harvey V. Fineberg, M.D., PhD., said in the foreword to the report. “We issue this report in the hope that it will prove useful to responsible government agencies, informative to the health professions, and public, and helpful in attaining higher levels of dental health.”

The IOM report and brief are posted online at www.iom.edu/Reports/2011/Advancing-Oral-Health-in-America.aspx

Making Coverage Matter: Pew’s 50 State Report on Children’s Oral Health

2011-05-24T08:38:00.000-07:00

On May 24th, The Pew Center on the States, with support from the DentaQuest Foundation and W.K. Kellogg Foundation, issued its second annual report, Making Coverage Matter: Pew’s 50 State Report on Children’s Oral Health.

The report reflects a concerted effort and notable improvement among many of the states during the past year, proving that system changes can yield positive results for states continuing to struggle to provide adequate oral health care for children.

This year, seven states earned ‘A’s including Alaska, Connecticut, Maine, Maryland, Massachusetts, Minnesota, and South Carolina. Of these, Maryland was the top performing state, meeting seven of eight benchmarks. In addition, 22 states improved their grades, six of which raised their grade by at least two letters.

But even ‘A’ states have work to do. In five of these seven states, most Medicaid-enrolled children went a full year without seeing a dentist. And the total underserved population of all 7 ‘A’ states is 2,854,594 people.

While this report highlights the hard work that has gone on across the country to educate the general public and policy makers about programs that reduce disease and increase access to oral health care, lack of access to dental care is still an unacceptably persistent problem. Every year, 16 million children go without dental care, placing them at great risk of getting cavities. Cavities are almost 100% preventable when children have access to prevention, education and treatment services.

Five states including Florida, Hawaii, New Jersey, Indiana, Montana, received ‘F’s from this year’s report. By adopting relatively inexpensive and cost-effective strategies, ‘F’ states could improve children’s dental health. For Florida, Hawaii and New Jersey, this is the second straight year receiving failing grades. Indiana and Montana fell from a ‘D’ to an ‘F’.

This report gets people talking about oral health—and that’s important because it serves as a continuing national call to action for all 50 states to do more to improve children's oral health.

So let’s keep talking. What do you think this report has accomplished? Have you seen any signs of change in your state? Please share your thoughts by commenting on my blog.

A copy of the report can be found on the DentaQuest Foundation’s website, www.dentaquestfoundation.org.

Maryland Dental Action Coalition Launches 5-Year Oral Health Plan

2011-05-18T06:05:00.000-07:00

On May 17, the Maryland Dental Acton Coalition proudly presented a 5-year (2011-2015) state plan to promote the oral health of all Marylanders. The plan addresses Maryland’s most critical oral health needs and capitalizes on available resources and data.

Speaking at the celebratory launch event is The Honorable Elijah Cummings, U.S. Congress, a long time supporter of oral health access for children in Maryland and across the United States. Also speaking are Delegate Keith Haynes, Maryland General Assembly, Renee Cohen on behalf of the Honorable Ben Cardin, U.S. Congress, Josh Sharfstein, Secretary, Department of Health and Mental Hygiene, Joseph and Madeline Misero, Katrina Holt, Chair, MDAC Maryland Oral Health Plan Committee, and Beth Lowe, Chair, MDAC. Also speaking is Ralph Fuccillo, President of the DentaQuest Foundation, which provided start up grant funds to MDAC.

Maryland has become a national model in improving the oral health of its citizens over the last decade. The roots of this process go back to 2007, following the untimely death of a 12-year old Maryland child from an untreated dental infection. A statewide Dental Action Committee (DAC) was convened by John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene (DHMH), with a specific charge to make recommendations to improve access to oral health care for vulnerable (disadvantaged and/or underinsured) children.

In 2010, the DAC transitioned to the Maryland Dental Action Coalition (MDAC), an independent, broad-based partnership of individuals working to make sure progress continued on the DAC’s recommendations for improving access to oral health care for all Marylanders. Last year, MDAC hosted an Oral Health Heroes Celebration to recognize the work of these oral health pioneers.

The Maryland Dental Action Coalition and its members initiated the development of a 5-year state oral health plan and offered guidance as it was developed. The process involved many individuals in state and local government, academic institutions, professional dental organizations, private practice dentists, community-based programs, the insurance industry, advocacy groups, and others. The goals, objectives and activities in the plan will be the basis for work of the Maryland Dental Action Coalition in the years ahead specifically for:
• Access to oral health care
• Oral disease and injury prevention
• Oral health literacy and education.

With the launch of the plan comes a new phase of collaborative action to improve oral health for Marylanders. MDAC is taking inspiration from Helen Keller, who once said, “Alone we can do so little; together we can do so much!”

A copy of the Maryland Oral Health Plan will be posted to the DentaQuest Foundation website in Reports: www.dentaquestfoundation.org/resources/reports.php

Eliminating Disparities; Promoting Health Equity

2011-05-13T11:58:00.000-07:00

Pictured:
Dr. Chester W. Douglass, Harvard University School of Dental Medicine and Harvard School of Public Health and Dr. Philip Woods, Periodontist and Reede Scholar.

Guest blog post by Ralph Fuccillo, President, DentaQuest Foundation

The DentaQuest Foundation was honored to sponsor the Reede Scholars 2nd Annual Health Equity Symposium held at Harvard Medical School on May 12, 2011. An audience of more than 75 leaders among the health professions, including community programming, health delivery systems, health plans and purchasers, large employers, government leaders, and health policy experts attended.

Reede Scholars are health care professionals (physicians, psychiatrists, psychologists and dentists) who are working from the grassroots level to the national level, in business, academia and government. This makes for a powerful network of individuals with numerous and varied talents, experiences and interests -- all focused on improving the health and well-being of underserved populations and racial/ethnic minorities.

The program is named to honor its creator and mentor, Dr. Joan Y. Reede, a pioneer in efforts to improve the representation of ethnic minorities in health services careers and founder of the Minority Health Policy Fellowship. Dr. Reede is an inspiration for thousands who seek to make a difference in the health of their communities. Reede Scholars are advancing public health goals that aim to remedy the root causes of poor health, chronic illnesses, morbidity and death and encouraging greater civic participation and support for improved health, community empowerment, and health equity.

The 2011 Health Equity Symposium explored Health Information Technology (HIT) as an approach to achieving health equity. Dr. David Blumenthal, the National Coordinator for Health Information Technology under President Barack Obama, spoke about the potential of health information technologies as a tool providers can use to better understand the socio-demographics of their patients and monitoring for disparities. Properly used, HIT has the potential to provide a rich and consistent profile of the patient to all his/her providers (medical, behavioral, oral health) not just for diagnosis but also as a point of engagement for patient education and lifestyle improvements.

Often, problems with access to dental care can be linked to the insufficient number of dental and medical provider groups with the experience and training to offer culturally competent care to the population as it is now. Investing in educational programs to diversify the student pool and provide consistent quality experiences outside of traditional clinics is nothing less than investing in the future. Sponsorship of the Reede Health Equity Symposium is one example of DentaQuest’s investments in public health dentistry, health equity and eliminating disparities.

DentaQuest shares the commitment that the return on these investments continue to add new professionals who enter public and private practice with the cultural sensitivity and training to meet the needs of the population as it is now and as it will change.

Penny Wise, Pound Foolish?

2011-05-06T05:44:00.000-07:00

This week, two news stories caught my eye. One, in the Washington Post, was about a vote taken in the U.S. House of Representatives to repeal mandatory funding for school-based health center construction. The other, in the Worcester, MA Telegram & Gazette, recalled the days when children in Worcester received their dental care within the public school system. That ended in the late 1970s when most school dental clinics were closed. And since then, the rate of dental disease in the city’s children has been on the rise. It also doesn’t help that the city of Worcester does not fluoridate its water supply.

Across the United States, school-based health centers are becoming an important vehicle for health care delivery for all children, but especially for poor, uninsured or underinsured children. Providing health services where children spend the greatest part of their day makes sense. It eliminates the biggest impediments to getting care – such as the parent/caregiver getting time off from work, finding a provider who accepts the family’s insurance plan, and securing appropriate transportation. School-based health centers help families too, especially when the providers introduce children, siblings and the extended family to community health resources that all can use.

School-based clinics are a first line of disease prevention and eradication. When children and their caregivers know what to do to take care of teeth, and when they are able to see a dentist when something is wrong, cavities are nearly completely preventable. And when neither of the above takes place, children can end up with serious decay and infections that require emergency room care and extreme interventions. (Read about Early Childhood Caries in this blog here and here.)

Today Worcester, MA is working to establish a pathway for young at-risk children and their families to a lifetime of good oral health. Through a pilot program, 730 Head Start children and their families are learning about oral health as part of classroom activities and parent meetings. They are introduced to the dentist as a friendly, supportive adult. Parents/caregivers get a colorful “Baby Tooth Timeline” -- a growth chart which tracks age, height and weight and provides useful dental health information for the child’s first five years. The chart explains when to expect first teeth, what to do to prevent decay, and when to schedule dentist visits.

The next step is to be sure the children have connections in the community to get care when they need it. Statistically, low-income children suffer from dental disease at much greater rates than the general population. Many Head Start children are covered by Medicaid; but not all dentists accept Medicaid patients.

And, not all school-based health centers provide dental services. We think they should. As the Worcester example shows, prevention works. It would be nice if the U.S .House of Representatives would reconsider their recent vote, and instead, approve the wise investment in school-based health centers.

Dr. Mark Doherty is Executive Director of the DentaQuest institute, a not-for-profit organization focused on improving efficiency, effectiveness and quality in dental care.

Keeping America’s Oral Health Safety Net Strong

2011-04-29T06:17:00.000-07:00

Ask any American what they think about healthcare reform and, for better or worse, you’ll probably find very strong opinions about the role of government and spending.

However, backstage, away from the public debate about the new law, a quiet revolution is underway to help the 59 million Americans who go without medical care and the 100 million who have not had dental care this year, get the care they desperately need.

It’s not the individual mandate or the state health exchanges. It’s the most significant investment in primary care you’ve probably never heard of—an $11 billion commitment to community health centers and $15 billion to prevention programs. It may sound like small potatoes compared to the estimated total cost of healthcare reform--$940 billion over 10 years--but the impact will be significant, especially for those who need it the most.

These funds, reopened for debate by Congress, would double the capacity of community health centers (CHCs) from serving 20 million people a year to 40 million. As the only access point for care besides the emergency room, CHCs provide critical prenatal care, behavioral health services, primary and specialty care for 1 out of 7 uninsured individuals. By 2015, with new capacity, CHCs will serve 1 out 3 uninsured.

Healthcare reform requires that CHCs offer oral health services. This means as many as 17 million children will get to see a dentist, some for the first time ever. Currently, these children are significantly underserved because they can’t access to care to prevent tooth decay and, once they have decay, to get timely treatment.

There’s a reason why former U.S. Surgeon General David Satcher declared childhood tooth decay a “silent epidemic”. 6.5 million children have untreated dental disease, the majority of whom are from low-income households. Half of these children are estimated to go to school with mouth pain—as children who cannot eat properly or pay attention in class and do well in school.

For infants 3 years old and younger, this can mean a mouth full of diseased baby teeth that can only be treated through surgical intervention. This is followed by a life time of being at greater risk for tooth decay, because the corrosive bacteria that cause tooth decay have colonized their mouths in greater proportion.

Tooth decay not only disrupts development and educational attainment, it can also turn deadly. The 2007 death of a 14-year-old Maryland boy is a tragic reminder of how one ‘simple’ toothache can develop into an unchecked infection that can quickly spread to the brain. His death could have been prevented with a timely dental care, but, at the time, oral health services were difficult to find for families on Medicaid.

From our work as president of a foundation focused solely on oral health and as a lifelong practicing dentist in both a private practice and a community health center, we see evidence every day of how oral health disparities in underserved communities are every bit as cruel as violence, inadequate housing, or poorly performing schools.

Fortunately, dental disease is nearly 100% preventable with education, regular check-ups for prevention, and treatment. That is why we’re committing DentaQuest Foundation resources to supporting and strengthening the community care safety net for oral health. We want to make sure that greater numbers of health centers will be prepared to provide effective, high-quality oral health services to children and families. The DentaQuest Institute and its Safety Net Solutions program are joining us to make sure that happens.

It may take decades before the impact of this investment in community health centers is fully appreciated. That’s okay. Today we are thinking about the millions of children who will have greater opportunity in life because of accessible health care.

Blog post by Ralph Fuccillo and Dr. Mark Doherty.

Ralph Fuccillo is President of the DentaQuest Foundation.
Dr. Mark Doherty is Executive Director of the DentaQuest Institute. Its Safety Net Solutions Program is helping community health center dental programs become more efficient, effective and financially stable.

What does Good Oral Health Mean to You?

2011-04-22T06:26:00.000-07:00

I spend a lot of time educating people about good oral health. And if you scroll through this blog, you’ll see there is a lot that can be said on the topic.

That made me wonder, what does good oral health mean to you?

I really would like to know.

Rating the Performance of Your State’s Health System

2011-04-15T07:12:00.000-07:00

There’s an interesting new report by the Commonwealth Fund, Securing a Healthy Future: The Commonwealth Fund State Scorecard on Child Health System Performance, 2011 that is worth looking at.

The Commonwealth Fund’s researchers took a number of objective measures for good health -- such as access to prevention and treatment, the potential to lead a healthy life (defined as factors such as low prevalence of specific health problems, low obesity, and lack of habits and behaviors that impact health, such as smoking) and socio-demographic dimensions (such as income and where you live) -- and looked at how each of these measures impact the others. The result is a very interesting and comprehensive picture of elements that contribute to children's health in each state.

We’re pleased that this report includes preventive dental care and the absence of dental problems as measures of access to prevention and treatment and a factor in healthy lives. The Report concludes that the high rate of poor yet preventable dental health outcomes among children in many states points to the need to improve preventive dental health care.

Better access to oral health services can reduce tooth decay and lead to a better quality of life for children, as well as reduce financial and societal costs. The Commonwealth Fund found that almost one third of children did not see a dentist for a preventive visit in the bottom-ranked state and more than 10 percent did not have a dental check-up in the top-ranked state. Want to know who they are? Click the link on the report title and check out the report!

Dental disease is nearly 100% preventable when people have access to information about keeping their mouths healthy and access to dental services. Public education, expansion of access to dental care, and integration of oral health into routine well-child care are smart ways to do this.

It works best when FAMILIES are able get the services they need to maintain their oral health since parents need dental care themselves for their own good health AND so they can be a good example for their children. The U.S. Department of Health and Human Services Healthy People 2010 goals recommend that children have at least 1 dental visit annually. And the American Dental Association says that you can start this at the age of 1 or when the first tooth erupts.

So, check out the data for your state. And then let me ask you -- is an annual visit to the dentist something that you do for yourself and for your children?

Report from the Field: National Oral Health Conference, 2011

2011-04-12T10:27:00.000-07:00

If you’re involved in public health dental care, are a health researcher, dental educator, legislator, public health official, Medicaid/CHIP dental program staff or consultant, or provide dental care at a community health center, chances are, you are in Pittsburgh, PA this week (April 11-13) at the National Oral Health Conference.

This is the 12th time the Association of State and Territorial Dental Directors (ASTDD), the American Association of Public Health Dentistry (AAPHD) along with the Centers for Disease Control and Prevention (CDC) have brought the national public oral health community together to highlight the many areas where public health systems can converge toward achieving “optimal oral health” for America’s citizens. As a leader in the national conversation about improving oral health for Americans, DentaQuest is playing a visible role.

The ASTDD board invited the leadership of the DentaQuest institute and the DentaQuest Foundation to its annual Board meeting to update them on the significant investments we have planned for 2011.

In the 1st general session of the conference, Mark Doherty, DDM, MPH, Executive Director of the DentaQuest Institute, Ralph Fuccillo, President of the DentaQuest Foundation and Marcia Brand, PhD, the Deputy Administrator of HRSA, walked participants through “Strategies for Achieving and Maximizing Return on Investment in Oral Health.” ARRA and the Affordable Care Act have made significant investments in the health safety net. Oral health programs will benefit. With good planning, this once in a lifetime investment can lead to increased access, improved oral health outcomes, and financial sustainability and potential partnership with private foundations to extend the dollars available for oral health expansion. DentaQuest Institute Director of Practice Improvement, Dr. Jay Anderson is representing the Institute on an ASTDD- and ADA-sponsored panel discussion on working in community health centers. The American Association of Medical Colleges Advisory Group on Oral Health Curricula is discussing adoption of the Smiles for Life online oral health training for health care clinicians.

The DentaQuest Institute is featuring information on Safety Net Solutions technical assistance services throughout the conference at its booth.

The DentaQuest Foundation and Institute look forward to these national events for the opportunity they provide us to connect with dental public health leaders from across the United States. It makes us better at the work we do with our partners in supporting effective approaches to preventing and caring for oral disease.

Blog post by Dr. Michael Monopoli, Director Policy and Programs, DentaQuest Foundation and Brian Souza, Managing Director DentaQuest Foundation and DentaQuest Institute, reporting from NOHC.

Smokeless Tobacco – YOU’RE OUT!

2011-04-08T07:03:00.000-07:00

Images of opening day should be of cheering fans, baseball diamonds, baseball caps and crisp new uniforms, and NOT containers of smokeless tobacco anywhere near the dugout. Smokeless tobacco in all its forms -- chewing, plug, twist, snus, snuff, dissolvable -- is a dangerous (and dirty) habit that I hope will no longer be glorified on baseball fields – professional or neighborhood. This year Congress is putting pressure on Commissioner Bud Selig and MLB players association chief Michael Weiner to ban smokeless tobacco all together this baseball season. I can’t agree more. We do not want impressionable children and teens to see their sports heroes using smokeless tobacco and get the wrong message about the dangers. Make no mistake about it, smokeless tobacco is dangerous.

Smokeless tobacco contains higher quantities of nicotine than most cigarettes. And it increases the likelihood that the person using it will become a smoker.1

It shocked me to learn that according to the Academy of General Dentistry (AGD) 4% of boys in middle school and 20% of high school boys use smokeless tobacco. Half of them will likely develop pre-cancerous white patches in their mouths. ·

Smokeless tobacco products, just like cigarettes, contain at least 28 cancer-causing chemicals. And the sugar that is often added to enhance the flavor increases the risk for tooth decay.2 ·

Smokeless tobacco is known to cause cancers of the mouth, lip, tongue and pancreas. Users may also be at risk for cancer of the voice box, esophagus, colon and bladder, if they swallow toxins in the juice.2

April isn’t just the time that baseball comes back in full swing; it’s also Oral Cancer Awareness Month. That makes this a great time to remind you that oral cancer affects males and females, adults and kids. And even if you are not a smoker, make sure your dentist does an oral cancer exam [pulls and twists your tongue] at every visit.

Please share these facts with the teens and youth in your life. And I’d be curious to know what they think about smokeless tobacco and keeping it out of baseball? Check out the facts:

Eradicating Early Childhood Caries

2011-04-01T07:11:00.000-07:00

This year, the Centers for Medicare & Medicaid Services and other experts estimate that more than 300,000 children under the age of six, many from lower-income households, will suffer from Early Childhood Caries (ECC) and require hospitalization. These young children often have a mouthful of cavities and a potentially life-threatening bacterial infection that may cause them to seek hospitalization. Another 1.5 million children are considered at risk for ECC. Hospital resources are so limited that children requiring operating room care at one of the few hospital-based dental clinics commonly wait up to six months before receiving treatment. In the meantime, parents rely on powerful antibiotics to keep the infection in check. (Not much can be done about the pain).

Early Childhood Caries can be prevented. But to do this, young parents need the right information about the oral health of their babies and toddlers in time to prevent infection. Without access to preventive education and care, children may find themselves facing rampant cavities, a hospital stay, and residual lifelong disadvantages—such as malnutrition, school absences, and missed work.

We at the DentaQuest Institute are tackling this preventable, chronic childhood disease head on. Working in partnership with researchers at Children’s Hospital Boston, we have developed a clinical protocol for treating Early Childhood Caries that works with primary care providers and parents to improve treatment in the hospital and, most importantly, at home. This program is using education and case-management to help change behavior at home and the dental office. Where this treatment plan has been used, we have been able to reduce the percentage of young children (under 60 months) with new cavities by 69 percent; reduced those who needed treatment by 55 percent; and reduced reports of children with mouth pain by 50 percent. The DentaQuest Institute is now working to expand the ECC program to 10 dental clinics across 8 states—including MA, RI, OH, NY, FL, CA, WA and NY. In many ways, Early Childhood Caries is a parable for what plagues healthcare: small problems that turn into big problems because the right information and resources weren’t available in the first place to stop the progression. Preventive health care is part of the solution, but it means nothing unless you know how to use it.

Dr. Mark Doherty, Executive Director, DentaQuest Institute and Dr. Jay Anderson, Director of Quality Improvement, DentaQuest Institute

Some Good News at Massachusetts’ Medicaid Dental Program

2011-03-07T12:59:00.001-08:00

This February, U.S. District Court Justice Rya W. Zobel ended 5-years of court oversight of the MassHealth (Medicaid) dental care program for low-income children.

This is a milestone to celebrate.

In 2005, as the conclusion to a class action lawsuit against the Commonwealth of Massachusetts, Judge Zobel ruled that Massachusetts children covered by the MassHealth dental program encountered “extraordinary difficulty” in obtaining timely dental care, and that the program violated federal Medicaid law. At the time, barely a third of eligible children Massachusetts were being treated by a dentist.

The judge ordered Massachusetts to bring the MassHealth children’s dental program into compliance with federal law and appointed a neutral Monitor, Dr. Catherine Hayes, to make sure the necessary changes were made.

Since then, Massachusetts has made significant improvements to its Medicaid dental program.

1. The state established a full time Medicaid Dental Director. Previously, there was a part-time leader/advocate for oral health.

2. The state hired a 3rd party dental management administrator (DentaQuest) to efficiently manage the processing of claims and to provide provider relations.

3. The Massachusetts legislature increased the fees paid to dentists treating Medicaid patients to a point far more comparable with the cost of providing care. Previously, dentists were reluctant to treat Medicaid patients. In 2009, the Massachusetts Dental Society set a goal to have 65 percent of its membership, including specialists, participate in the MassHealth program by the year 2013. New dentists are joining MassHealth every day.

These changes are making a difference. In 2010, 50% of the children in the program saw a dentist compared to 33% before 2005. So after reviewing the current data, Judge Zobel declared the MassHealth dental program free to function without a guardian.

In Massachusetts, there are other good news events for children’s oral health. School-based programs are now in place across the state, some state-funded and some funded by private philanthropy-- they provide dental examinations including placing dental sealants (thin plastic coatings on molars) and fluoride treatments on children’s teeth to protect against cavities. And, MassHealth is now paying pediatricians and nurse practitioners when they apply fluoride treatments and advise parents and caregivers on how they can help prevent cavities in children.

That’s not to say that there still aren’t oral health challenges in Massachusetts. Benefits are closely tied to the economy and the state’s budget. In 2010, dental benefits for adults in the MassHealth program were cut back. Adult benefits are vulnerable because states are not required to provide them, even though doing so makes good sense. Parents’ dental coverage is a good predictor of whether or not their children will obtain dental services.

Despite economic challenges, more Massachusetts children are getting good preventive dental care, and that’s great news.

Using Performance Measurement to Improve Oral Health and Patient Care

2011-02-25T07:08:00.000-08:00

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!

2011-02-09T14:23:00.000-08:00

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!

Best Practice Management Consultant, 2011

2011-01-28T12:06:00.000-08:00

My colleague, Safety Net Solutions founder and DentaQuest Institute Executive Director Mark Doherty, DMD, MPH, CCHP was recognized as Best Practice Management Consultant in Dr.Bicuspid’s 2011 Dental Excellence Awards. Dr. Doherty is a passionate advocate for oral health, and has a strong background in public health dentistry. Under his direction, the DentaQuest Institute’s Safety Net Solutions program has helped strengthen many dental clinics in communities across the country.

The Safety Net Solutions program is unique among dental management consultants because it is focused on the urgent need to preserve and strengthen the oral health safety net which serves 16 million+ uninsured and medically underserved Americans every day. Oral health safety net providers are the dentists who work at your local community health center. They are critical to good individual and community health. But they are very challenged by poor reimbursement, operational difficulties, and limited resources. Historically, these programs struggle to maintain financial viability.

The DentaQuest Institute’s Safety Net Solutions (SNS) program works collaboratively with program administrators, dental directors, and staff. Its advisors provide customized technical assistance to enhance the business infrastructure behind the delivery of care—with an appreciation for the uniqueness of safety net clients and their care needs. The SNS Improvement Model is especially helpful for programs in environments with low levels of public reimbursement because it teaches programs to operate more efficiently. Many public and private funders of safety net sites have started including Safety Net Solutions technical assistance in their plans to ensure that grantees implement sustainable, results-oriented business practices, and develop access metrics that deliver a return on the investment.

Since the program began in 2006, SNS has worked with more than 90 safety net dental programs in 19 states. And they are now advising the growing number of community health centers that are starting new or expanding existing dental programs, using critical resources mandated in health reform.

Safety Net Solutions is making a difference. Within one year of receiving SNS technical assistance, a dental care safety net program is stronger.

Overall, through technical assistance, sites experienced on average…
· 35,063 more dental visits in the past year
· An increase of 1,594 visits
· Gross productivity increased by $752,006
· Net revenue of dental services increased by $5,475,937

The Dr.Bicuspid award is a well-deserved recognition of Mark’s hard work and the DentaQuest Institute’s leadership in strengthening America’s dental safety net and innovating improvements to the care delivery system.
Learn more about the Safety Net Solutions program at www.dentaquestinstitute.org/safetynetsolutions

The Cost of Treating a Preventable Disease

2011-01-21T05:21:00.001-08:00

This is pretty interesting stuff. Dental expenditures in 2007 (latest available) equaled the cost of treating cardiovascular disease. It is more than twice as much as was spent for diabetes or normal maternity. And it is mostly caused by a little bacteria that can be prevented!

Source: Medical Expenditure Panel Survey 2007, AHRQ, US Dept of Health and Human Services

Community Water Fluoridation Rules Change

2011-01-14T12:04:00.000-08:00

Last Friday, the U.S. Department of Health and Human Services (HHS) and the U.S. Environmental Protection Agency (EPA) issued the first changes in the recommended amount of fluoride for public drinking water supplies in nearly 50 years.

Public health officials and professional dentistry believe that water fluoridation and fluoride toothpaste are largely responsible for the decline in tooth decay in the U.S. over the past several decades.

The new guidelines set a balance where people will be able to get tooth decay prevention benefits while avoiding unwanted health effects from too much fluoride. Consuming too much fluoride during the years when teeth are forming (8 years old and younger) may lead to a condition called dental fluorosis where light white markings or spots become visible on the tooth’s enamel.

Over the last 50 years, Americans have access to more sources of fluoride than they did when water fluoridation was first introduced in the 1940s. Water is just one of several sources which also include toothpastes and mouth rinses, prescription fluoride supplements, and fluoride applied by dental professionals.

Read the full press release at http://www.hhs.gov/news/press/2011pres/01/20110107a.html

How to Prevent the Gift of Cavities

2011-01-07T10:32:00.000-08:00

Caregivers need to watch their mouths around children. I’m not talking about what they say—I’m talking about what they spread (cavities).

Most people don’t know that very young children can “catch” the bacteria that causes cavities. But they can.

Cavities (caries) are a bacterial infection. Now here’s a really interesting fact: babies most often get this bacteria from family members. How does a child get the bacteria? Most likely, it is through some form of exchange of saliva from an adult or another child in their lives.

Think about how this can happen. It can be through something as harmless as sharing a spoon, ‘cleaning’ the pacifier that fell on the floor in your mouth before returning it to the child, or biting off a piece of apple to share with a child. The bacteria in the adult’s mouth just found a pathway to the child.

Once in the child’s mouth, the cavity-causing bacteria cling to the surfaces of the teeth like a film. Your dentist calls this biofilm. Acids in the bacteria eat away at the enamel (the hard coating of the tooth), and can cause white spots. If you see these, they are early signs of cavities. Call your dentist! Untreated, the next step is a cavity (hole) in the enamel. If the infection is caught early, your dentist can remineralize and ‘heal’ the tooth—no drilling involved! This is most often done with a high concentration of fluoride.

Once cavity causing bacteria are in a child’s mouth, they are there for life. Caregivers have to be on top of what goes into the child’s mouth. Watch out for:

- Sugars and acids in foods and drinks – they encourage the cavity-causing bacteria to multiply. Did you know that the milk in a baby’s bottle contains sugars? Or that fruit juices, soda, sports and energy drinks are full of sugars and acids too? Starting when the child is an infant, wipe the inside of a baby’s mouth with a soft wash cloth after eating to reduce the acid attacks on the teeth.

- Be sure to only give water to baby at bedtime or naptime. Putting a child to bed with milk, juice or soda (all sugary and/or acidic drinks) is just feeding the bacteria and encouraging the start of cavities.

- Clean the child’s teeth every day. If the child is too young to brush his or her own teeth, wipe the teeth with a soft, clean, damp washcloth. As the child is able to cooperate, you can brush the teeth using a pea-sized dot of fluoride toothpaste. Once a child is 4 or 5, he or she can brush on his/her own with parental supervision. (Be sure the child spits out and does not swallow the toothpaste.) It is important to remove food from all the surfaces of the teeth every day so the bacteria can’t settle in and start the decay process.

Untreated, tooth decay can have serious, negative effects on a child’s physical and educational development. Mouth pain makes it difficult to eat a healthy diet, to learn to speak properly, and to concentrate in school. Untreated tooth decay in baby teeth can damage a child’s permanent teeth. Plain and simple, early tooth decay can quickly put kids at a lifelong disadvantage.

What can parents do? Taking care of your teeth improves your own oral health, and sets a good example for your child to follow. Make sure you visit your dentist regularly. Take your child for a first check-up at twelve months of age. The dentist will determine the child’s risk of developing dental disease. Follow a healthy diet and be sure to brush after every meal.

Taking care to reduce the risk of transmitting cavity-causing bacteria to children will better position them to fight off tooth decay as they grow.

A Resolution to Smile About

2010-12-14T12:14:00.000-08:00

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

2010-12-02T07:19:00.000-08:00

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

2010-11-19T12:00:00.000-08:00

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

2010-11-10T05:52:00.000-08:00

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

2010-11-03T08:58:00.000-07:00

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

2010-10-27T09:14:00.000-07:00

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

2010-09-29T13:23:00.000-07:00

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

2010-09-22T14:08:00.000-07:00

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

2010-09-17T11:44:00.000-07:00

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)!

2010-09-09T06:21:00.000-07:00

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

2010-09-01T07:45:00.000-07:00

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

2010-08-19T09:38:00.000-07:00

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

2010-08-12T07:17:00.001-07:00

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

2010-07-30T08:21:00.000-07:00

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

2010-07-22T07:37:00.000-07:00

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

2010-07-14T08:59:00.000-07:00

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

2010-07-07T05:59:00.000-07:00

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

2010-06-30T06:35:00.001-07:00

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

2010-06-23T10:55:00.000-07:00

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

2010-06-14T10:59:00.000-07:00

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

2010-06-07T12:52:00.000-07:00

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

2010-06-02T04:31:00.000-07:00

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

2010-05-26T08:46:00.000-07:00

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

2010-05-13T06:01:00.000-07:00

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.

Drink fluoridated water and use fluoride toothpaste. This is good protection against tooth decay at all ages.
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.
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.
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!
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

2010-05-05T05:15:00.000-07:00

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

2010-04-27T11:35:00.000-07:00

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:

110 people every day are diagnosed with an oral cancer
1 person dies every hour of every day from oral cancer
Anecdotally, on the oral cancer foundation survivor list, about 1/3 are under 30 years of age
There seems to be a correlation with the HPV virus and oral cancers
In 2007 oral cancers rose 11%
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

2010-04-20T04:32:00.000-07:00

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

2010-04-06T10:30:00.000-07:00

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

2010-03-31T13:19:00.001-07:00

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

2010-03-22T14:31:00.000-07:00

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

2010-02-25T14:29:00.000-08:00

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

2010-02-23T06:05:00.000-08:00

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

2010-02-16T10:00:00.000-08:00

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

2010-01-29T06:28:00.001-08:00

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

2010-01-13T05:47:00.000-08:00

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.

A Resolution to Smile About

2009-12-18T11:57:00.000-08:00

The many family and social gatherings between Thanksgiving and New Year’s Day are trying times for your waistline … and for your teeth.

Americans consume roughly 675 million pounds of turkey on Thanksgiving Day. Billions of candy canes are eaten each holiday season and each person puts away an estimated 12 pounds of premium chocolates. Almost all of our favorite holiday treats are filled sugar that could all take a serious toll on your teeth.

And it’s not just the food. Americans drank enough last year for every person to have had 7 bottles of liquor, 12 bottles of wine, and 230 cans of beer. If you don't make good decisions about what you are eating and drinking, or properly clean your teeth afterward, you could end up with tooth decay, gum disease and possible tooth loss.

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

If you drink wine, choose red over white. White wine is more acidic than red wine and it contains more sugar, making it more harmful for your teeth in the long run. Researchers say contact with white wine erodes the tooth’s protective enamel - making teeth more sensitive to cold, hot and sweet food.

Regardless of the color of the wine, rinse your mouth with water before brushing your teeth. Brushing immediately after consuming wine, a very acidic beverage, may damage the tooth's structure. Give your mouth’s saliva time to re-mineralize the tooth structure and neutralize possible damage. So wait, and then rinse with water before brushing.

If you choose to drink spirits or liquor, the opposite is true. Opt for lighter or clear liquids to avoid higher sugar content. Also, be aware of the sugar content of your favorite mixers. And as with the wine, rinse your mouth with water after you drink and before you brush your teeth.

Eat some cheese. The mouth naturally becomes more acidic after eating to aid digestion. Cheese keeps the mouth less acidic and therefore healthier for teeth. Cheese also coats the teeth with calcium and prevents demineralization. (And consider this -- chewing sugarless gum increases saliva, which helps clear food from tooth crevices and replaces essential minerals on teeth. We recommend gum with the sweetener Xylitol which is a natural cavity fighter.)

Consume candy in moderation – sugar free if possible. If you are choosing between a candy cane and a piece of chocolate, go with the 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.) Also, avoid biting directly down on hard candies to avoid fracturing a tooth.

Resolve to floss at least once a day this next year. If you are already a flosser, good for you. If you aren’t, or are only flossing sparingly, make a resolution to add this to your family’s daily routine. To get you started, most dentists give you a free trial size to ease you into this great lifelong habit.

No matter how exhausted you may be from hosting your family or attending your fifth party in a row, 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 lot of damage that you could have been prevented with 2 minutes and a toothbrush. Do the same in the morning --keep in mind plaque builds up even if you haven't eaten anything for 8 hours.

Good dental habits throughout the holidays – and year round – will help make for a happier New Year. As you make plans for 2010, I hope you all will resolve to be better to your teeth because that’s something we can all smile about.

Guest Blog Post by Dr. Linda Vidone, Associate Dental Director for DentaQuest

Dental Care as an Essential Benefit

2009-12-11T11:58:00.000-08:00

When times are tough and people tighten their belts and family budgets, visits to doctors and dentists often get cut. Even relatively small co-pays can be justification to skip a check-up, renew a prescription, get an annual dental cleaning, or even get a small cavity filled. Unfortunately, ignoring routine care can have serious consequences.

Many States are facing budget challenges as well. As legislatures work to close shortfalls in state budgets, dental benefits provided through Medicaid are being cut or eliminated. This year, California, Hawaii, Massachusetts, Michigan, North Carolina, and Washington have considered funding cuts to, or elimination of, dental benefits. The numbers are significant –California stands to save about $614 million per year. Massachusetts hoped to save $60 million a year, but a recent upturn in revenue has put proposed cuts on hold. That is positive news for Massachusetts because the impact of the proposed cuts would have been staggering. The Massachusetts Medicaid program provides dental services to more than 1 million of the state's low-income seniors, chronically ill, and people with disabilities. That is almost one in ten of the state's neediest residents.

There's a great misconception that dental care is not one of the essential types of health care that people need. Not true. Dental care is critical to everyone’s good health and wellbeing. According to the U.S. Department of Health and Human Services and the American Dietetic Association, a variety of medical conditions – such as diabetes, heart disease, HIV, and complications of pregnancy—have been associated with poor oral health.

When states are forced to make cuts in Medicaid-sponsored dental programs, there are consequences. One is an increase in the numbers of patients with illnesses that could have easily been prevented. Fixing a chipped tooth right away, or filling a cavity when it is small is simpler, less painful, and less costly than waiting for the issue to escalate to a larger, more complicated dental infection. A second consequence is an increase in emergency room and other triage costs -- which taxpayers ultimately pay for -- as patients desperate to relieve mouth pain are left with no other options for care. When an individual visits the emergency room because of mouth pain, the pain may be addressed, but the cause of the problem is often not treated. This leaves the patient vulnerable to more severe problems, which ultimately become more costly to treat.

These are facts. Dental disease is nearly 100% preventable. Dental benefits help people get the care they need in good times and in tough times. Making sure dental care is an essential benefit in state Medicaid programs makes good sense.

Guest Blog Post by Steve Pollock, President of DentaQuest Government Business

Is Anyone Listening?

2009-12-03T11:13:00.000-08:00

Sometimes, at the end of the day, I wish I believed that there was a single politician in Washington who wanted to understand dental insurance.

I am a dentist. And, for the past 20 years, I have been chief dental officer, first for a medical insurance carrier and now, for a dental insurance carrier. One of the reasons I was attracted to my current position is the singular mission of this organization to improve the oral health of the residents in the regions we serve through dental benefits, through research into better ways to deliver care, and through philanthropy that extends oral health services to underserved groups. When your one and only focus is dental benefits, you want your offering to be the best – in prevention services and in reimbursement for dental work when it is needed.

With half of all dental payments being made by insurance companies, many of the improvements in the care you receive at your dentist are made possible thanks to forward thinking dental carriers. Do you have children? Dental carriers led the way with coverage for sealants and fluoride treatments because they help prevent cavities. Have gum disease? Dental carriers paved the way for multiple cleanings and screenings each year. Other innovations? How about coverage for brush biopsies, localized antimicrobials that halt gingivitis in adults, risk-based care and benefits, disease management programs, oral health report cards, and prevention-focused care.

For medical carriers, dental is a plan enhancement, an add-on commodity that can be downsized, restructured, or even eliminated when the carrier needs to meet bottom line demands. Medical plans don’t innovate in the area of dental services, and only sometimes do they watch dental carriers closely and copy new benefits that are popular and financially advantageous. Medical carriers often use the same customer service staff to respond to medical and dental calls, which may leave the caller wondering if the customer service representative understood their questions about tooth decay and gum disease.

So I am concerned that one of the current health reform bills under consideration advocates bundling essential dental services for children into medical plans offered under the Exchanges. And I am concerned that none of the bills include dental benefits for adults. It’s a bad idea to separate children’s coverage from their parents. If parents don’t see a dentist because they don’t have dental insurance, then chances of their children seeing a dentist drop significantly. Keeping standalone dental carriers among the options on the Exchanges makes sure cost effective and prevention-focused innovations in dental benefits will continue. That is the kind of innovation that makes care more efficient and keeps health care costs under control. Without proper support for oral health, current health reform proposals may actually undermine the progress we are making as a nation toward improved oral health and add new barriers to care for the individuals and families that this reform legislation is intended to help. Good oral health is critical for the entire family—parents and children alike.

Healthy Smiles in Miami Dade Schools

2009-11-18T06:58:00.000-08:00

We know from the successes of several of the DentaQuest Foundation’s grantees in Massachusetts that portable, school-based dental programs are a proven, effective public health approach to bring oral health services to children. Properly designed school-based programs can overcome many barriers that make it difficult for children to get care -- barriers such as parents getting time off from work to accompany the child, finding transportation to the dentist, and providing regular preventive oral health services for children participating in the Medicaid program.

This fall, the DentaQuest Foundation and the Miami-Dade office of Doral Dental, partnering with the Health Foundation of South Florida, The Children’s Trust, and two Miami community health centers, saw the start of the Healthy Smiles in Our Schools program in 17 public schools in Miami-Dade County.

The goal of Healthy Smiles is to increase the number of children receiving dental exams and treatment and to deliver these services in a practical and cost-effective way – at school where the children spend most of their day. Healthy Smiles is working in partnership with Health Connect in Our Schools, the healthcare program operated by The Children’s Trust in Miami Dade public schools.

The Healthy Smiles program is an example of how public education, philanthropy and public health in Miami Dade are working together to create a lasting solution for the oral health needs of South Florida’s children. Regular prevention measures like dental exams and putting dental sealants on the molars of adolescents can prevent dental disease that interferes with a child’s learning, speech, and eating, and which often leads to poor nutrition and problems in school.

Two community health centers, Borinquen Health Care Center and Community Health of South Florida, are the anchors for the project, providing the dental exams and treatment. The school-based program is an opportunity to provide necessary preventive care to children in Miami-Dade County and to connect their families with the clinics for ongoing comprehensive health care.

We are very proud to be part of this creative and practical partnership of healthcare, education and philanthropy.

Guest Blogging by Ralph Fuccillo, President, DentaQuest Foundation

Health Reform: Put Teeth in the Debate

2009-11-13T12:46:00.000-08:00

While oral health is often overlooked in health policy discussions, it remains an essential element for good overall health. Dental health coverage from private insurers like DentaQuest embodies the best elements of a good health care system: it is relatively inexpensive and it promotes preventive care and early intervention.

It is good to see the provisions in the House of Representative’s bill, Affordable Health Care for America Act (H.R. 3962) that include children’s dental care in the essential benefits package. The procedures to be included in the essential benefits have not been discussed yet, but we are hopeful that organized dentistry will have an opportunity to outline the set of essential benefits. Adult dental coverage is not included in the reform bill, so while children might be insured through the “Exchange”, their parents would have to seek coverage in a different plan.

That would have the unintended consequence of dividing children’s coverage from their parents. Good oral health is critical for the entire family—parents and children alike. If parents don’t see a dentist because they don’t have dental insurance, then chances of their children seeing a dentist drop significantly. And that may mean that many childhood diseases, like early childhood caries – an entirely preventable bacterial disease—are less likely to be caught and treated early.

Americans understand how important dental coverage is to them and their families. In a recent poll by Oral Health America, nearly two out of three U.S. adults (63 percent) agree that dental coverage should be part of an overall health reform package. Forty percent believe this is very important.

Despite these facts, the recent discussion of health care reform has ignored oral health, rather than including it as a critical element of comprehensive health care.

The Senate Finance committee proposal has a solution that works for families. It allows family dental coverage to be offered through a dental insurance company and still makes sure that children’s dental needs are covered. Since over 97% of Americans currently receive their dental benefits this way today, please join me in letting your Senators know that you want family coverage to continue.

Whitening vs. Bleaching: What to Know Before you Undergo

2009-10-28T08:13:00.000-07:00

White teeth look healthy and a pretty smile usually brings a return smile from those we meet. So if you have been thinking about whitening your teeth, but just don’t know much about it, let me remove the mysteries for you.

Whitening is defined as removing stains so the teeth are clean and as white as they can be. Bleaching is defined as altering the natural color of the teeth, and making them whiter by the use of bleaching agents.

This information alone can help you understand the advertisements for whitening toothpaste, mouthwash and chewing gum. These are merely stating that they have been shown to remove stains from the surface of a tooth.

Bleaching is analogous to frosting a piece of clear glass. Bleach and peroxide penetrate the enamel of a tooth and give it a frosty white appearance. This appearance can remain indefinitely if bleaching agents are used regularly. However, if bleaching is a one-time experience, then the teeth will lose the frosty white appearance over time (usually around 6 months) and the natural tooth color will return.

Be careful though, as teeth are bleached they become more porous and this can cause sensitivity to cold air and water. Many dentists recommend toothpastes that reduce sensitivity for their bleaching patients. Other than the sensitivity, there are usually no other side effects when used as directed. The temptation to exceed the recommendations for bleaching however, can lead to chemical burns on the gums and oral tissues.

The difference between the bleaching kits available at the drug store and those used in the dental office is the concentration of the bleaching agent. The higher the concentration of bleach, the quicker the result, and the higher the incidence of sensitivity. In the long run, over the counter bleaching reaches the same results as the professional bleaching, but it may take several months to achieve the same whiteness as the one hour bleaching in the dental office.

Take Some Candy, Leave the Cavities

2009-10-21T07:08:00.002-07:00

Plastic vampire teeth, as popular as they may be on October 31, are no replacement for your child’s own teeth.

While any candy should be consumed in moderation at all times 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.

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 brushing, bacteria in the mouth will feed on the sugars and turn them into acid. This acid then attacks tooth enamel and causes tooth decay, i.e. cavities.

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.

Here are a few guidelines to safeguard your children’s teeth as they savor their sweets:

Look for Halloween treats that can be eaten quickly, like miniature candy bars.
Sugar free gums that use Xylitol, the all natural sweetener, are a great candy alternative. Chewing gum with Xylitol helps prevent cavities and also neutralizes the effects of sugar from the candy.
When you get home from trick-or-treating, discard hard or sticky candies like sugared fruit snacks, caramels, popcorn balls or lollipops. 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 not a good idea for children to graze on candy from after school until dinner time as this 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.
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. According to the American Heart Association, women shouldn’t eat more than six teaspoons of sugar a day, about the amount of sugar in a candy bar, and men shouldn’t consume more than nine teaspoons a day. On average, Americans consume 22.2 teaspoons of sugar each day.

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.

Dear Readers

2009-10-15T06:02:00.000-07:00

I have some great news to share with you. The National Association of Dental Plans (NADP) has reelected me to their Board of Directors to serve a second three year term (2010-2012) with the group.

NADP is the largest non-profit, national trade association focused exclusively on the entire dental benefits industry, i.e. dental HMOs, dental PPOs, discount dental plans and dental indemnity products. They are the recognized leader of the dental benefits industry, which includes over 173 million covered Americans.

Service with professional organizations like the NADP compliments my work with DentaQuest as well as other dental and community organizations. I share this with you not to pat myself on the back, but to highlight the importance of collaboration within the industry as NADP’s mission –which mirrors our own - is to promote and advance the dental benefits industry to improve consumer access to affordable, quality dental care.

To find out more about what the NADP is up to, please visit http://www.nadp.org/.

Preventing Flu Starting with Your Toothbrush

2009-10-08T14:05:00.001-07:00

With cold and flu season upon us, and all the concern about H1N1, almost daily we are reminded about washing our hands to prevent the spread of germs and bacteria. But it is just as important to pay attention to your toothbrush, where germs collect and can be spread.

With this in mind, I want to share a couple of helpful oral health tips that could prevent you from catching a cold this season or worse yet, the flu.

1. Replace your toothbrush often. Most people replace a toothbrush after four months of use, but it really should be changed every two to three months. In any case, get a new brush at the start of an illness and always replace your brush after a cold or flu – which most people don’t think to do.

2. Sterilize your toothbrush and you should do this once or twice a week – especially if someone in your home is sick. The microwave is one option. Put the toothbrush in a microwave-safe cup with 2-3 inches of water and bring the water to boil in the microwave for 3 to 4 minutes. If you are cleaning the brush for your electric toothbrush, submerge the entire brush in water, then bring the water to a boil for 3 to 4 minutes. (This is important to prevent sparks if your brush has a metal connector on it.) The kitchen dishwasher is another great way to sterilize a toothbrush. Just put the brush in the silverware basket when you run a load of dishes. Dishwashers are the nearest thing we have in our homes to the steam autoclave used in the dentist’s office. Cleaning your toothbrush is a good habit to adopt year-round, as there are plenty of germs and bacteria floating around the bathroom eager to cling to your toothbrush.

3. Store your toothbrush away from others in the house, use a toothbrush cover if possible, and always store it upright. Airborne bacteria can move easily from toothbrush to toothbrush, so any way you can limit contact with other toothbrushes is beneficial. Plain soap and water can be used to clean a toothbrush as well as our hands. Also, remember that the tube of toothpaste contacts the bristles so germs can spread from one person to another this way. When you’re sick, it is a good idea to use travel toothpaste or squirt the toothpaste onto your clean finger and then apply to your toothbrush.

4. Wash hands before and after brushing. Bacteria from your hands and food particles from your mouth are unavoidable, but washing your hands – before AND after – can help prevent oral inflammatory disease caused by these kinds of bacteria.

Good dental habits are very important to a healthy body. So take care this cold and flu season and please contact me if you have any questions about these or other oral health tips.

Dental Check-up Should be a Back-to-School Basic

2009-09-22T06:23:00.001-07:00

Backpack. Check. Pens and pencils. Check. Organizers and notebooks. Check. You’ve gotten your child everything they may need to be back at school, but there may be a very important item missing from your back-to-school check list: your child’s dental check-up.

Dental caries, also known as tooth decay, is the most common chronic childhood disease, five times more common than asthma. It’s also completely preventable with proper care. Good oral health is an important part of a child’s overall well being, especially as they and their teeth are developing.

Dental check-ups are crucial to identify risks and help prevent more serious problems from occurring such as tooth decay and gum disease. Dentists can even identify early signs of other diseases like diabetes and vitamin deficiencies. However, without regular dental screenings and prevention measures like sealants on molars, dental disease often goes untreated and can result in cavities, pain and infection. Untreated dental disease can also interfere with learning, speech, and eating, leading to poor nutrition and problems in school.

You can also help your child protect their teeth throughout the school year with a few simple tips:

Sugar and acid in soda and sports drinks can eat away tooth’s enamel: if your children are drinking these, send them to school with a straw so the liquid will have less contact with their teeth.
Most bottled water doesn’t have tooth decay fighting fluoride: you can save money by skipping the bottled water and having your child drink water from the tap using a tap filter or a filtered pitcher.
Chewing gum doesn’t have to be bad for your child’s teeth. Always use sugarless gum and look for chewing gum with xylitol, the natural sweetener that has been proven to help prevent tooth decay, listed as one of the top three ingredients.
If your child participates in a school sport, make sure he/she wears a mouth guard. According to the American Dental Association, sports-related injuries knock out two million teeth per year. Your child will be 60 times less likely to suffer tooth damage than an athlete without a mouth guard. (Mouth guards are rarely covered by insurance plans because of the wide variation in cost between custom, mouth-formed and stock ones -- any mouth guard is better than none.)

Most importantly, schedule an appointment with your child’s dentist. Start a positive tradition that will hopefully last them their entire lives. Your child should walk away with a new toothbrush, a sticker and a brighter smile. You will walk away with peace of mind, knowing you have a full picture of your child’s overall health and that your son or daughter is truly ready to for this new school year.