Mission of Mercy - Wise County Fairgrounds, VA

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

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

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

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

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

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


Guest blog post by Fay Donohue, CEO, DentaQuest.

Bringing Oral Health Awareness to Capitol Hill

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

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

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

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

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

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

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

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

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


Guest Post by Fay Donohue, CEO, DentaQuest

Chipped, Broken and Bruised Teeth

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

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

When a tooth chips or cracks:

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

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

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

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

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

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

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

Injuries to Permanent Teeth

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

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

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

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

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

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

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

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

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

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

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

Stay Cool and Hydrated

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

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

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

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

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

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

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

Mouth piercings: Let a healthy smile make the fashion statement

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

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

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

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

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

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

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

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

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

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

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

Men’s Health and Wellness: Oral Health

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

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

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

Things to keep in mind:

Do you take medications?

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

Do you smoke or use tobacco?

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

Do you play sports?

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

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

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