Archive for November, 2010

Gum Disease Linked to Alzheimer’s

Monday, November 29th, 2010

Just in time for National Alzheimer’s Disease Awareness Month this November, a new study from  the NYU College of Dentistry has found a link between gum disease and an increased  risk for developing Alzheimer’s disease. In 2008, Dr. Angela Kamer worked with researchers from Denmark to “analyze[] data on periodontal (gum) inflammation and cognitive function in 152 Danish men and women who were part of the Glostrop Aging Study, which gathered medical, psychological, oral health and social data from 1964-1984.” From this study, Dr. Kamer concluded that “subjects with Alzheimer’s disease had a significantly higher level of antibodies and inflammatory molecules associated with periodontal disease in their plasma (blood) compared to healthy people.”

Dr. Kamer’s most recent study involved drawing comparisons between the cognitive abilities of research subjects at ages 50 and 70 by “using the Digit Symbol Test, or DST, a part of the standard measurement of adult IQ that assesses how quickly subjects can link a series of digits, such as 2, 3, 4, to a corresponding list of digit-symbol pairs.”

The researchers discovered that those with gum disease at age 70 had much lower DST scores and that these same subjects were nine times more likely to achieve lower range DST scores than individuals with some or no evidence of gum disease. What’s more, the association between low DST scores and gum disease remained true even for individuals with multiple other risk factors for low DST scores, such as tooth loss unrelated to gum inflammation, cigarette smoking and obesity. The association was also strong for subjects with low DST scores at age 50. Dr. Kramer comments, “The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation.”

Vanessa Hurley

Teeth-Healthy Foods

Saturday, November 27th, 2010

We think about eating well for our heart, our skin, and even our eyes, but what about our teeth? Here’s a guide to some of the most essential foods for maintaining healthy teeth (and a healthy body)! Bon appetit!

Calcium is one of the most important nutrients for healthy teeth. You can find it in milk, fortified soy and rice drinks and salmon.

Since cavities can largely be prevented by fluoride, it can be helpful to search out fluoridated water and teas in addition to the fluoride found in most toothpastes and mouthwashes.

Healthy formation of tooth enamel requires phosphorus (supplied through meat, fish and eggs) and magnesium (in whole grains, spinach and banana).

Vitamin A is also essential for healthy teeth; beta-carotene is what the body needs in order to make an adequate amount of Vitamin A. Beta-carotene can be found in orange-colored fruits and dark leafy greens.

Fresh fruits are a fantastic way to maintain healthy teeth. Although fruit can be sweet or acidic (or both), stimulation of saliva production from eating fruit helps wash away the acidity as well as any lingering food particles in the mouth. Apples are a particularly good choice since they stimulate saliva flow as well as the gums thus reducing the amount of particles left over in the mouth which can lead to decay.

One good indication that your diet may be lacking in Vitamin C is bleeding gums. Eating fresh fruits and vegetables every day, including harder, fibrous ones (like celery or carrots) can help keep gums healthy.

Vanessa Hurley

Reprint of Putting Teeth Into Health Reform

Tuesday, November 2nd, 2010

In April, 2009, two COHI members, dentist Toby Kravitz and foundation director Tom Roberts, teamed up to write an op ed piece that ran in The Valley News.  The article is reprinted here, in its entirety:

Putting Teeth into Health Care Reform

There’s a communicable disease rampant in many people’s bodies.

Untreated, it can lead to organ loss, the possibility of abscesses, brain infection and even death. It is the most common chronic disease in children. If this disease occurred anywhere else in the body, the Center for Disease Control would likely have declared a public health emergency.

But the body part affected is our mouths. The organs are our teeth. The disease is caries, better known as dental decay or cavities.

In Vermont and New Hampshire, we can see the signs of an oral health crisis taking place around us: People walking into emergency rooms with so much pain that they are begging to have their teeth pulled out. Too many young adults have mouths riddled with bad teeth and need of dentures or a mouthful of extensive and expensive dental care.

A local organization, the Ottauquechee Health Foundation, provides grants on behalf of individuals who can’t afford their health care for those who live in their service area. Oral health requests now pre-dominate. Last year, two-thirds of applications and two-thirds of dollars went to dental needs.

Studies show that poor oral health impacts overall health, leading to chronic pain and making it harder to succeed in school or find a job. Yet we have a health care system that continues to treat the mouth as if it was not a part of our body. And there’s a different tolerance of what’s acceptable in the way of disease, chronic pain and risk to the body. There is a different set of insurances for dental care, both private and public. Only half the population has dental insurance.

People without sufficient insurance and people without the means to pay for dental care are going without the oral health care that they need. Those with Medicaid struggle to find a dentist who will treat them. Adults on Medicaid are faced with restricted benefits and limited access.

Although many area dentists do take Medicaid patients, donate their time or work for reduced fees for needy patients, many do not. Why don’t more take Medicaid? The reimbursement rate is less than 65 percent of the true cost, which does not allow dentists to cover their overhead rates. Others are concerned about a higher no-show rate for these appointments. The limitations on Medicaid dental benefits for adults create additional barriers.

A doctor in an emergency room doesn’t get paid any less if her patients don’t pay their bills, nor does a primary care doctor working for a hospital see their salary decline if a patient doesn’t show up. Most dentists on the other hand, have small offices, with one or two dentists, where there is a direct connection between who pays and what the practice’s income looks like at the end of the month.

Too many people do not place a priority on their personal oral health. Some have learned from their parents that they likely will lose all their teeth before they are 60 and don’t even try to keep up oral hygiene.

Concerned about oral health needs in the Upper Valley, a dedicated group of dentists, health care providers and funders have formed the Community Oral Health Initiative to look for solutions to our communities’ oral health needs.

How will we improve our oral health? There are roles for all of us to play. We all need to recognize as a matter of public policy that oral health needs to be on par with other health care needs. Then coverage for care and proper reimbursement rates need to be prioritized so that they are aligned with other health care needs.

Dentists will play a part. As the Medicaid scope of coverage and rates improve, more dentists will participate in the program. Dentists will continue to volunteer their time at free clinics like the Red Logan. And they will continue to forgive a portion of their fee to participate in Ottauquechee’s Good Neighbor grant program. If there is community interest perhaps that program might extend beyond the Woodstock area to cover the entire Upper Valley.

And each of us has a role. We can help change community norms so that all children grow up expecting to have a healthy set of teeth. We need to each take personal responsibility for our oral health care and for that of our children. The basic preventive steps—brushing, flossing, eating snacks like apples that clean our teeth in the middle of the day and staying away from high sugar foods, especially sipping on soda and energy drinks throughout the day—can go a long way to ensure we only need to visit our dentist for regular preventive appointments.

Our oral health must become a priority, both in the Upper Valley and in the rest of the country. It is a problem that is ours to solve and solutions are within our reach, so that everyone, rich or poor, has the same access to care for a hole in their teeth or gums as for a hole in their arm.

As national attention turns to health care reform, one message we ought to all agree on is that we must put teeth into health care reform.

Toby Kravitz, DDS, is a Norwich dentist and chair of the Community Oral Health Initiative. Tom Roberts is the director of the Ottauquechee Health Foundation and past chair of COHI.

Tom Roberts