Friday, December 18, 2009

A Resolution to Smile About

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

Friday, December 11, 2009

Dental Care as an Essential Benefit

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

Thursday, December 3, 2009

Is Anyone Listening?

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.

Wednesday, November 18, 2009

Healthy Smiles in Miami Dade Schools

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

Friday, November 13, 2009

Health Reform: Put Teeth in the Debate

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.

Wednesday, October 28, 2009

Whitening vs. Bleaching: What to Know Before you Undergo

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.

Wednesday, October 21, 2009

Take Some Candy, Leave the Cavities

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:
  1. Look for Halloween treats that can be eaten quickly, like miniature candy bars.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

Thursday, October 15, 2009

Dear Readers

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

Thursday, October 8, 2009

Preventing Flu Starting with Your Toothbrush

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.

Tuesday, September 22, 2009

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

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.