‘Action for Dental Health’ in Congress

While we all paid close attention to health care in the Senate last week, the House Energy and Commerce Committee made a critical, yet mostly overlooked step to advance oral health for at-risk populations.

On July 27^th, the Committee unanimously passed HR 2422, or the Action for Dental Health Act of 2017. This bill calls for Congress to authorize additional oral health promotion and disease prevention programs to help at-risk populations struggling to obtain appropriate oral health care.

The bill points out that more than 181 million Americans will not see a dentist, but almost half of people ages 30 and older have some form of gum disease and nearly a quarter of children under age 5 already have cavities. 

As we at DentaQuest well know, caries is the most prevalent chronicdisease among children and can be prevented. What’s more, we see time and again that Americans of all ages are in desperate need of access to oral health care - Missions of Mercy like the one in Wise County, Va., is a great example. Both the Washington Post and The New York Times covered the July event, for which thousands of people come from miles away and lineup for hours and even days just to get access to dental and other services.

If this new legislation passes through Congress, the Centers for Disease Control and Prevention will award grants and collaborate with states, counties, public officials, or other stakeholders to implement a variety of initiatives.

These activities could include oral health programs that:

·         more broadly use portable/mobile dental equipment;

·         facilitate the establishment of dental homes;

·         eliminate geographic, language, cultural, or other barriers to care;

·         reduce the use of emergency departments for dental conditions; and

·         provide dental care to nursing home residents.

It is exciting to see bipartisan support for dental care initiatives that have tremendous impacts on the oral and overall health of patients. This type of work will drastically improve the health of Americans. And it has the ability to address the estimated $2.6 billion in free care that dentists currently deliver, as well as the nearly $2.1 billion spent on dental cases in hospital emergency departments – 80 percent of which could be treated in a dental office for roughly $4 million total, according to the bill.

Bipartisanship like this must continue and we urge legislators to make oral health a critical component of any health reform legislation that passes through this Congress. 

Make This a Fall for Smiles!

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.

Tooth protection: Sealants for better oral health

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.

Related Posts:
· Some Good News at Massachusetts’ Medicaid Dental Program
· Healthy Smiles in Miami Dade Schools
· Washington’s Unseen Oral Health Debate
· Let’s Talk About the Oral Health of America’s Children
· Is Anyone Listening?

Sip Safely

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.

Eradicating Early Childhood Caries

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