Hispanic Oral Health

By Dr. Doyle Williams, Chief Dental Officer

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

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

Some of the key findings include:

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

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

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

X-Rays: Do the Risks Outweigh the Benefits?

By Dr. Doyle Williams

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

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

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

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

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

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

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

Oral Health Literacy Workshop

Dr. Doyle Williams, Chief Dental Officer

What’s your oral health IQ?

If you read this blog, you know that

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

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

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

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

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

Diabetes and Your Oral Health

By Dr. Doyle Williams, Chief Dental Officer

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

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

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

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

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

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

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

Senator Bernie Sanders' Brings Oral Health to Capitol Hill

By Steve Pollock

Vermont Senator Bernie Sanders recently called attention to America’s dental crisis during a panel discussion and Q&A on Capitol Hill. "This is an issue that is of huge consequence but doesn't get the kind of attention that it deserves,” Senator Sanders commented, as reported by WCAX.

The recent coverage of America’s oral health crisis is rewarding to witness, since the topic typically gets little attention in the media. In addition to Senator Sanders’ report, a New York Times article reported on the rise of preschoolers requiring surgical dental work to remove extensive tooth decay and the startling prevalence of dental disease among youth in our country.

Senator Sanders’ report underscores the fact that more than ten years after the U.S. Surgeon General called dental disease a “silent epidemic” not nearly enough has been done to address the oral health crisis in America today.

The key findings from Senator Sanders’ report include:

• More than 47 million people live in places where it is difficult to access dental care.
• About 17 million low-income children received no dental care in 2009.
• One forth of adults in the U.S. ages 65 and older have lost all of their teeth.
• Low-income adults are almost twice as likely as higher-income adults to have gone without a dental check up in the previous year.
• Bad dental health impacts overall health and increases the risk for diabetes, heart disease, and poor birth outcomes.
• There were over 830,000 visits to emergency rooms across the country for preventable dental conditions in 2009- a 16% increase since 2006.
• Almost 60% of children ages 5 to 17 have cavities- making tooth decay five times more common than asthma among children of this age.
• Nearly 9,500 new dental providers are needed to meet the country’s current oral health needs.
• There are more dentists retiring each year than there are dental school graduates to replace them.

Senator Sanders concludes with several recommendations, including placing an emphasis on prevention and education and integrating dental services into nontraditional settings such as schools.

At DentaQuest, we couldn’t agree more. Good preventive care and early diagnosis of dental disease are the keys to improving oral health.

In our dental benefits business, we are committed to partnering with participating dentists across the country to help them target higher-risk patients in their practices and ensure they get the preventive care they need to better manage dental disease. My colleagues at the DentaQuest Institute are doing amazing work with dental programs in safety net health centers, private dental offices and hospital-based clinics across the country developing effective ways to prevent and manage oral disease. That includes effective new care protocols that are helping preschoolers with serious cavities stay out of the operating room! Check out this piece about the work the DentaQuest Institute supported at St. Josephs’ in Providence, Rhode Island on treatment of early childhood tooth decay.

Tooth decay is nearly 100% preventable with education, preventive services and access to care. How many diseases can you say that about? Prevention is the key to stopping this chronic and costly disease. So grab a tooth brush, remember to floss, see your oral health professional regularly, and enjoy the many benefits of good oral health.

More Prevention, Less Emergency

By Dr. Doyle Williams

I’ve been reading way too many articles about the increasing use of the hospital emergency room (ER) for treating dental problems. Hospitals are saying that this has become a very frequent occurrence. It saddens me to know people are in such mouth pain that they need ER intervention. It is troubling to me as a dentist because when an individual visits the hospital with a dental emergency, the pain will be addressed, but the “root” cause of the problem is often not treated. The most common treatment is a prescription for pain and another for infection; both are just temporary fixes. This leaves the individual vulnerable to a recurrence of the same problem in a few weeks or perhaps more severe problems, which ultimately become more costly and painful to treat. And in some cases, they can be life threatening.

The number of ER visits across the U.S. increased by 16 percent from 2006 to 2009. Did you know that between 1.3 percent and 2.7 percent of all ER visits that don't result in a hospital admission are dental emergencies? In many cases, the people using the emergency room have had difficulty getting regular preventive care from dentists and other types of providers says The Pew Research Center in its report, A Costly Destination. Unfortunately, the patients who find themselves in the ER are paying more than they would have at a dentist, and not solving their underlying oral health problem.

Consider that a single ER visit for toothache pain can cost Medicaid about $236, while extracting an infected tooth in a dentist’soffice or placing a filling would cost about $107. Recognizing this trend, the National Institutes of Health is supporting a new two-year study of emergency room dental care.

We need to take a closer look at where money is spent on dental care. Paying for prevention-focused dental care is a more effective wayto keep costs down. As the saying goes, “An ounce of prevention is worth apound of cure.”

DentaQuest is committed to prevention in oral healthcare. Click here to learn more http://www.dentaquest.com/Preventistry/.

Oral Cancer and HPV

By Dr. Doyle Williams

Oral Cancer will inflict 37,000 people this year. It will cause 8,000 deaths. It is a silent killer that takes the life of one person every hour.

Oral cancer can often be detected with a simple screening, and is often easily treatable in its early stages. But all too often it goes unnoticed until it’s too late.

Warning signs of oral cancer include:

A red or white patch in your mouth or a sore that hasn’t healed within 14 days.

Sore throat or ear pain caused by inflammation in the back of the throat. If the pain lingers after two weeks, consult with your physician.

A lump in your neck, which may signify the cancer is spreading out from its original site.

Alteration in the quality of your voice or hoarseness for no apparent reason that hasn’t disappeared after about a week.

Today, many cases of oral cancer are being caused by Human Papilloma Virus, commonly known as HPV, an STD that nearly 80 percent of Americans will be infected with at least once in their lifetime.

There are more than 120 strands of HPV, not all of which are cancerous. The virus can be passed through sexual activity, and in most cases has no side-effects and is gone within a year. But in rare cases, HPV can turn into oral cancer, making it all the more important to be screened regularly for both HPV and oral cancer.

So don’t forget to insist on an oral cancer screening with your dentist at least once a year, even if you have no known risk factors like tobacco and alcohol.