Archive for September, 2010

A History of the Toothbrush

Thursday, September 30th, 2010

Thomas P. Connelly D.D.S. has written a fascinating article on the history of the toothbrush on the Huffington Post website. From the Egyptians’ creation of “tooth powder” in 5000 B.C. to the first U.S. patent for the toothbrush in 1857, Dr. Connelly discusses it all. Check out his post for more quirky facts about the  “invention that Americans said they couldn’t live without” here.

Vanessa Hurley

Healthy Teeth for a Healthy Heart

Monday, September 27th, 2010

A new report from the British Medical Journal states that brushing your teeth may be an important way to help your heart. Scottish researchers examined the toothbrushing habits of over 11,000 men and women over the course of eight years. Those individuals who rated their oral hygiene habits as poor (indicating that they “rarely/never brushed their teeth”) experienced a 70% increased risk of cardiovascular events versus the group reporting good oral hygiene. The group with poor brushing habits “also had increased concentrations of both C reactive protein and fibrinogen” which are considered markers of inflammation. The authors write that “inflammation plays an important role in the [development] of atherosclerosis, and markers of low grade inflammation have been consistently associated with a higher risk of cardiovascular disease.” Although additional research has found a link between inflammation and heart disease, the authors are careful to state that “future experimental studies will be needed to confirm whether the observed association between oral health behavior and cardiovascular disease is in fact causal or merely a risk marker.”

Click here to read the full study.

Vanessa Hurley

Making Strides Toward Better Oral Health in Claremont

Monday, September 27th, 2010

Although the Community Dental Care Center in Claremont, NH has only been open for a little over a year, over 1,200 patients have already had their oral health needs addressed by the center’s staff, according to an article by Angel Roy on July 7, 2010 in the Eagle Times. On the day of the dental center’s opening, June 23, 2009, office manager Carolyn Girard commented that a line of people could be seen outside the front door. That line was but one indication of the distinct need for oral health services for Claremont residents that Karen Dewey and members of the Sullivan County Oral Health Collaborative spent much time and energy trying to understand. With funding from the New Hampshire Department of Health and Human Services, the Endowment for Health and the city of Claremont, the Collaborative took it upon themselves to initiate the planning needed for a project of this type.

Housed in Opera House Square, the seven-person staff at the dental center helps patients with a variety of insurance types, from New Hampshire Medicaid and Healthy Kids to self-pay patients. Dewey attributes the project’s success to the fact that it is a center rather than a clinic, allowing the dental practitioners to “serve everybody because everybody needs a dental home,” as Dewey puts it.

Since the opening of the dental center, Dr. Charles Sawyer, a staff member of the emergency medicine department at local Valley Regional Hospital has noticed “a decrease in patients accessing emergency services for dental issues, such as the need for extractions.”Although New Hampshire Medicaid only covers emergency services related to adult dental needs, the dental center has provided accessible, affordable care to individuals who might not otherwise find it. Both Dewey and her husband have seen the need for oral health in the Claremont community since they moved there 34 years ago. Dewey’s husband, a physician’s assistant, commented after his first day of work, “I cannot believe the dental disease.” Dewey comments that “I started the oral health collaborative seven years ago – 27 years later we were still talking about dental disease. That’s absurd.”

What Roy makes clear in her article is that the dental center’s existence was rooted in the identification and action of the collaborative as well as other Claremont citizens who see the center as a stride toward finally addressing a long-seated community need.

The Top 5 Ways to Prevent Cavities

Monday, September 27th, 2010

To paraphrase a well-known aphorism, the price of eating ice cream is eternal vigilance. If, like me, you have a sweet tooth, then one thing you need to consider is how to keep that sweet, sweet rocky road from leading to bitter, bitter tooth decay.

When it comes to cavities, the name of the game is prevention. And the best way to fight cavities is to make sure you never get them in the first place. To that end, the American Dental Association offers these guidelines for preventing cavities in children, teenagers, and adults.

From the website of the American Dental Association:

Preventing Decay:

  • Brush your teeth twice a day with fluoride toothpaste.
  • Clean between teeth daily with floss or an interdental cleaner.
  • Eat a balanced diet and limit between-meal snacks.
  • Visit your dentist regularly for professional cleanings and oral exams.
  • Ask your dentist about dental sealants, a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.

Visit the ADA tooth decay page to learn more.

Dennis Pacheco and Vanessa Hurley

Ending a “Silent Epidemic”

Monday, September 27th, 2010

It’s been called a “silent epidemic,” affecting almost 45% of children 6 years of age and younger nationwide. (1) In Vermont, it affects 16% of third graders and in New Hampshire 24% of third graders. According to the CDC, it’s five times as common as asthma and 7 times as common as hay fever (2).

It may surprise you to learn that this epidemic is actually childhood tooth decay. Whether or not you were aware that tooth decay is such a pervasive childhood disease, its prevalence should suggest the importance of early dental appointments for young children. Heidi Arndt, a dental hygienist and writer from RDH Magazine, reports that the American Academy of Pediatric Dentistry (AAPD) advises parents to ensure that a pediatrician perform a basic oral health assessment six months after the appearance of a child’s first tooth and that a child’s first dentist visit should occur no later than the first birthday. Arndt states that early dental appointments are “critical to identifying early signs of ECC [early childhood caries (or cavities)], providing guidance and counsel on long-term treatment, and getting parents and children in the habit of visiting the dentist regularly.” What’s more, research has suggested that young children who visit a dentist have a greater likelihood of receiving regular preventive cleanings and are far less likely to visit a dentist for restorative reasons. Preventive screenings can help ensure that cavities are treated early or prevented altogether, thus saving children from losing teeth at an early age.

Although Arndt’s message is surely meant to highlight the necessity of dental appointments for very young children, she is quick to acknowledge yet another foundational aspect of the prevention of dental caries – the oral health of expectant mothers. This includes more than just conversations with mothers about ways to maintain her own oral health as well as that of her “soon-to-arrive baby.” She states that it is a “common misperception among dentists…that you can’t treat women while pregnant,” while the reality is that “it is safe to treat women up until birth” with the “best window…[being] between 14 and 20 weeks, according to the New York Department of Health.”

Above all else, prevention is key. You can’t help but be shocked by the fact that a disease which is 100% preventable affects almost half of all children in the U.S. under 6 years old. If prevention begins while the mother is pregnant and continues into the early months of a baby’s life, caries will become a “silent epidemic” of nothing more than the past.

1 Arndt, Slowing the Silent Epidemic

2 CDC Children’s Oral Health page

Vanessa Hurley

What Health Reform Means for Oral Health

Monday, September 27th, 2010

As the excitement surrounding President Obama’s historic health reform legislation begins to settle, plenty of questions remain about how our health care system will be changed. We’re particularly interested by how the new legislation will affect oral health care in this country.

The Maine Dental Access Coalition offers a great overview of the ways in which health reform is expected to impact oral health for Americans. Some of the highlights include:

-Insurance plans created for the uninsured through state exchanges will be required to provide pediatric oral health services and prevent any patient out of pocket expenses for preventive services.

-Rebates will be used to pay for dental services provided through Medicare Advantage plans.

-Medicaid and CHIP Payment and Access Commission must create a report for Congress summarizing reimbursements to dental professionals for services rendered through these programs.

-Grants for school health centers to provide oral health services.

-Establishment of a 5 year oral health campaign which will focus on advocacy and education for the prevention of childhood caries and oral health care for pregnant women and other vulnerable populations.

-All states, territories and Indian tribes will receive funding for school-based sealant programs. This marks a fundamental change in policy since there are currently only 16 states receiving federal funding for these types of programs.

-The CDC will bolster its relationship with all states and territories to create a comprehensive oral health infrastructure to include continuous data collection, interpretation, delivery system improvements and science-based population programs

-Oral health reporting for pregnant women through Pregnancy Risk Assessment Monitoring System (PRAMS) will become mandatory (currently this reporting is optional).

-All states must participate in the CDC’s National Oral Health Surveillance System (only 16 states currently participate).

-A 5 year, $4 million 15 site demonstration project will be launched to train “alternative dental health care providers”

-Support will be provided for training general, pediatric and public health dental professionals and the establishment of a dental faculty loan repayment program for faculty engaged in public health and primary care dentistry.

Visit the Maine Dental Access Coalition’s Public Policy page for a full description of how health reform will impact oral health care.

Vanessa Hurley

A New Type of Dental Provider

Monday, September 27th, 2010

In early 2009, the Minnesota legislature took a step toward improving dental service access for low-income residents. Surprisingly, the law does not concern increasing dental provider reimbursement rates or improving the quality of school-based oral health programs, but rather paves the way for the training of a new type of dental provider known as a dental therapist. A two-and-a-half-year program that would follow a traditional 4-year bachelor’s degree, the dental therapist program at the University of Minnesota trains individuals to be the dental version of a physician’s assistant. Dental therapists will be trained to provide “relatively simple services such as filling cavities, instructing patients in dental hygiene and performing dietary evaluations and oral cancer screenings.” (1)

While dental therapists will be able to practice outside of dentists’ offices, their work will nonetheless be supervised by dentists who may be off-site. The University of Minnesota program will place each of its nine enrollees into dental professional shortage areas throughout the state with the hope that the reduced cost of their services (as compared to that of dentists) will extend the reach of access to those in lower income brackets.

Minnesota is not the only state which has shown interest in exploring the possibility of new types of dental providers. Since 2003 the state of Alaska has made use of dental health aide therapists (or DHATs) to provide needed services for residents who may be a boat or plane ride away from the nearest practicing dentist. Although the original DHATs were Alaska residents trained in New Zealand who returned to their homes to practice, since 2007 the DHATs have been trained in the U.S. thanks to collaboration between the University of Washington School of Medicine Physician Assistant Training Program and the Alaska Native Tribal Health Consortium.

The fundamental question surrounding the dental therapist model has increasingly become one of quality. The American Dental Association (ADA) has noted that the scope of procedures performed by dental therapists should be limited as their professional training does not match that of a dentist who commits to a minimum of 4 years of professional study. Nonetheless, the Alaska program’s utilization statistics “suggest that dental therapists are improving access to year-round oral health care for individuals who previously could see a dentist only a few weeks each year.” (2) While more extensive evaluation remains to be done, it seems clear that if a balance between practice capabilities and supervision is established, the dental therapist may offer an effective means of providing the most vulnerable populations with quality dental care.

Watch this interesting video about the dental therapist model to learn more about how it’s being used in Alaska.

References:

(1) Minnesota Public Radio
(2) Agency for Healthcare Research and Quality

Vanessa Hurley

There’s an App for That?

Monday, September 27th, 2010

Although the iPhone has only been around for 3 short years, not a day seems to go by without hearing the phrase “there’s an app for that” at least once. iPhone applications range from useful to intriguing to just plain kooky (iVoodoo, anyone?). Health apps in particular are becoming increasingly popular, with health-related apps for the iPhone alone reaching almost 6,000 according to a report by mobihealth news (1).

Since we’re always thinking about oral health, we decided to investigate whether apps related to the health of one’s teeth exist too. We’re happy to report that they do! Whether you’re looking for adult or children oriented oral health apps, Apple’s got you covered. The best part: Most are free!

Below is a list of some iPhone oral health apps we found particularly interesting. We hope you do as well.

Brush: (free) A toothbrush timer app that lets you know when to alternate brushing to a different section of the mouth.
Brush It Up ($0.99) – A game which increases in difficulty over time to teach kids how to effectively brush teeth.
CavityFree 3D (free):  Teaches patients how to correctly brush and floss teeth by using 3D demonstrations. This is a particularly helpful app for those with braces
Checkdent (free):  Features up-to-date videopods about dental health and treatments. Topics of interest include bleaching, implants, braces and periodontitis.
Checkdent Pro ($1.99) Similar to Checkdent, but features live operation videos.

Reference: Mobi Health News

Vanessa Hurley