Halloween 2015 Treat Tips: Here's How to Protect Kids' Dental Health

Around this time every year, parents have to contend with two main questions -- should kids be allowed to enjoy their Halloween candies and will parents spoil the fun if they prevent their children from having the treats?

According to CBC, despite warnings by dentists about cavities, the experts know that they can't stop the children from eating these during Halloween. So instead of being a party pooper, dentists are now suggesting ways to let the kids and their parents their enjoy Halloween treats all the while maintaining their dental health. 

Below are some of the tips parents can keep in mind:

1) Have kids eat a full and healthy meal before heading out for some trick or treating. Kids will full stomachs are less likely to reach into their bag of treats to eat.

2) Insist on a rule with the children, in that they must only eat the candies after these have been sorted at home. Parents remember, you must diligent about the sorting. Keep in mind that not every treat the kids receive should be consumed, some can be donated. Ask your family dentist if they have buyback programs for Halloween and take advantage of this.

3) When sorting, parents need to keep this in mind: sticky, hard and sour candies are the worst candies to have as these cause more damage to the teeth. These types of candies stick in the groves or may cause the teeth to chip off when biting. Sour candies are especially bad for the teeth's enamel, shared Dr. Terry Alani via ABC 13. She suggested that chocolates are better than other candies since this just melts in the mouth and washes off easily.

4) Let the children enjoy their treats in small quantities at a given time only, and after consuming these, let the children drink water. The fluoride in the water can wash away cavities. "The additional water swishing through your mouth might also help remove some sticky substances from your teeth," wrote Dr. Susan Maples via Mod Bee.

5) Last and definitely not least, there's nothing like brushing teeth after eating candies. Parents need to make sure that kids spend time brushing their teeth before going to bed. For younger children especially, use this time as an opportunity to teach kids about the importance of dental care. Join your kids and brush together and teach them the right way to floss, too. Let the children know that caring for the teeth is important every day, and not just during Halloween. If possible, set a dental appointment after Halloween as a preventive method.

Source: http://www.parentherald.com/articles/11950/20151030/halloween-2015-treat-tips-heres-how-to-protect-kids-dental-health.htm#ixzz3q4sPoNKR

In other dental news: Aurident's 3D dental scanners offer superior quality for both model and impression scanning. The Optimet DS 6000 Scanner uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans. The DSi 6000 Impression & Model Scanner overcomes the limitation of other scanners by accurately scanning impressions and models where other scanners have difficulty.

How to be thrilled in dentistry (for the first time?)

Introduction

Do you feel unfulfilled and fundamentally unhappy in dentistry? Fifteen years into my dental career, I was feeling just like that-tired, depressed, and frustrated with my current situation. My daily work had become mundane, and simple patient and staff complaints were beginning to get to me. Dentistry-or, to be more accurate, my dentistry-wasn't cutting it anymore.

Sadly, polling those attending my lectures has revealed a huge number of dentists in this group. But, if this is you, what are your alternatives? You can linger in misery until retirement, which unfortunately is further off than you think. You could scour the want ads for other careers, but what else are dentists trained for? Or, you can make your dental world a more rewarding one. The key is understanding how . . .

Choose your passion

What would you love to accomplish in dentistry? I discovered that I love to treat complex, cosmetically oriented cases. Does that inspire you? Would scanning and milling your own restorations (e.g., IPS e.max CAD, Ivoclar Vivadent), placing implants, or providing quality digital dentures in less time (e.g., Pala Dentures, Heraeus Kulzer) rock your world? Would helping save lives and putting less stress on your own body by treating sleep apnea patients (e.g., Sleep Group Solutions; AADSM) make you happier? Would you like to provide more esthetic and minimally invasive direct composite restorations (e.g., Estelite Omega, Tokyama; Empress Esthetic, Ivoclar Vivadent)? Would treating developmentally disabled patients give you the fulfillment you don't have now? Does getting more involved in the dental health of your community sound exhilarating to you? Would you like to give back to the profession and younger dentists by teaching? Thinking about (and then working toward) what excites you is key to being thrilled with dentistry.

Although I graduated from one of the country's most prestigious dental schools, I'd learned how to fix teeth, not how to repair a smile, a headache, or joint issue. I never really learned what ideal is, so I didn't know how to get my patients there.

And, like many dentists, I was intimidated by complex cases. When I realized I wanted to do more comprehensive dentistry, I needed to know where to start. My answers to questions such as how to alter someone's bite or how to make an attractive smile more stable were, ironically, found in publications that had been available for years. These included an article written by Pete Dawson, DDS, which caused a light bulb to go off-I needed more education.

I attended a weekend session at the Dawson Academy in St. Petersburg, Florida, about complete dentistry, and so began the transformation of my dental career. I embarked on an adventure of learning how to fabricate a functional, comfortable smile, and soon realized I was halfway through a 10-year plan to improve my dental world! By spending about two weekends per year investing in my new skills, I changed the course of my career.

My next goal was learning how to make a newly stable smile more esthetic. After reading about the American Academy of Cosmetic Dentistry (AACD), I attended the annual scientific session in San Diego, California. I learned from many industry leaders, including Corky Willhite, DDS; Brian LeSage, DDS, FAACD; and David Hornbrook, DDS, FAACD, FACE. At the session, these educators demonstrated their aptitude for conservative dentistry and their willingness to help you become an expert yourself. It was one of the most influential weeks of my life, during which I learned just how well dentists could transform smiles.

The AACD educators' engaging and helpful nature inspired me to maintain my motivation and, in 2007, to create a New York AACD affiliate chapter, the Empire State Academy of Cosmetic Dentistry (ESACD). Today, the ESACD is a vibrant and successful organization on its own. I have had the opportunity to not only participate in my local affiliate chapter, but currently serve on the AACD Board of Directors as well. Due to the exceptional training and rigorous curriculum, the AACD accreditation track produces the finest dentists and laboratory technicians in the world. By becoming an active member in the AACD, I have gained clinical knowledge and colleagues-both dentists and dental laboratory technicians-who challenge me and inspire my dentistry to fly to new heights.

There are many reputable organizations and instructional institutes through which you can achieve the level of education, training, and support you need and desire. The Dawson Academy is a great resource for advancing your skills and understanding of complete, predictable, and quality dentistry. Spear Education, led by Frank Spear, DDS, MSD, is another avenue that can help you become the dentist you have always wanted to be. John Kois, DMD, MSD, is another outstanding mentor, and at the Kois Center he demonstrates new technology and skills that are essential to improving clinical practice.

For those with a passion for short-term orthodontics, Invisalign, Six Month Smiles, Fast Track, and Inman Aligner Therapy all have training programs and courses available. The American Academy of Implant Dentistry is also an excellent resource for those interested in becoming more proficient at placing implants.

Align yourself with experts

Once you've become more skillful and are ready to venture toward your chosen path, it's important to remember that you cannot do it alone. Choosing and aligning yourself with appropriate colleagues is essential.

Specialists. Choose your specialists well. They can contribute to your success if they value your referrals, and consider you a partner. These relationships can contribute to a better dental life, one in which these specialists advise you, assist you, back you up on your suggestions to patients, and help to increase treatment plan acceptance. Periodontists, oral surgeons, orthodontists, and endodontists are key to creating a successful treatment plan. If you don't have confidence in your current specialists, find clinicians who you do trust.

Laboratory technicians. Modern technology makes it possible to select and work with a laboratory technician who is equally or more knowledgeable than you are about esthetics, material properties, and function-regardless of where they're located. Although my practice is in New York, I work with laboratories in Virginia, Utah, California, and Arizona. With a variety of educational programs available, laboratory technicians can receive advanced training from those who have mastered the field. An AACD- accredited laboratory technician is invaluable, as they truly understand all of the nuances of today's comprehensive esthetic dentistry.

Manufacturers. New and clinically researched materials like lithium disilicate (IPS e.max, Ivoclar Vivadent) are transforming how functional, durable, and strong restorations are fabricated with natural-looking esthetics. Likewise, zirconia options have evolved and now exhibit fine translucencies that are appropriate for use in the esthetic zone. It's therefore important to understand today's material properties and their indications. Attending seminars that carefully explain the advantages and disadvantages of today's restorative materials is essential.

Reputable manufacturers are continually creating and improving products to make dentists' work more efficient, predictable, and esthetic. Products from Ivoclar Vivadent (IPS e.max, Variolink Esthetic, Tetric EvoCeram Bulk Fill, etc.) work seamlessly together. Pala Digital Dentures from Heraeus Kulzer feature a 2- or 3-step denture system that is incredibly light and offers an exceptional fit. Other composite materials (e.g., Ivoclar Vivadent Empress Esthetic, Tokuyama Estelite Omega, etc.) offer beautiful and truly chameleon-like effects. Don't be afraid to learn about and try new products to improve your dentistry and practice.

Let your confidence show

When you understand new techniques, materials, and technology, you radiate confidence. That confidence is contagious, leading staff and patients to trust you more, suggest and accept treatments, respectively, and refer friends and family.

Work with people who make you-and your patients-smile

You spend dozens of hours each week with your team-more waking hours than with your family. Choose staff members who are fun, happy, intelligent, and outgoing. Hiring people that you want to see every day makes a huge difference in your practice and life! And chances are patients will want to see them, too.

Help others

After I began building "better bridges," treating headaches and migraines, and creating smiles I never dreamed I could accomplish, I decided to do one more thing that changed my dental world forever: giving back! The joy of helping someone else in need trumps anything you can do to help yourself. Treating a broken tooth that someone couldn't afford to fix for 20 years makes you feel euphoric. I began working with Great Shape International, the largest humanitarian dental project in the world. This year marks my eighth year doing volunteer smile improvements for those in need in Jamaica. In addition to this organization, there are a variety of others (table 1) that dentists and dental professionals can volunteer with, improving lives locally and all around the world.

Conclusion

The ultimate result of taking this approach has been fulfillment in dentistry that I never thought possible. I have a better staff and a happier me, and I'm more excited than ever in my chosen profession. So, stop trudging up those stairs every night and complaining about how distressing your day was. You can do something about it! Dig deep, decide what excites you, and what you're passionate about, and then reach out and learn how awesome dentistry can be!

Source: http://www.dentaleconomics.com/articles/print/volume-105/issue-10/practice/how-to-be-thrilled-in-dentistry-for-the-first-time.html

In other dental news: Aurident offers the Optimet DS 6000 Scanner which uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans.

The DS 6000 Scanner can be used for all dental applications such as copings, full contour crowns, bridges up to 14 units, implants, implant bars and dentures.

Diabetes screening in dental offices

In April 2013, a report was published from a workshop involving the American Academy of Periodontology and its European counterpart, the European Federation of Periodontology, on periodontitis and systemic diseases.¹ The authors stated, "Over the last 20 years, consistent and robust evidence has emerged that severe periodontitis adversely affects glycaemic control in diabetes and glycaemia in nondiabetes subjects. In diabetes patients, there is a direct and dose-dependent relationship between periodontitis severity and diabetes complications. Emerging evidence supports an increased risk for diabetes onset in patients with severe periodontitis.. ... Randomized controlled trials (RCTs) consistently demonstrate that mechanical periodontal therapy associates with approximately a 0.4% reduction in HbA1C at three months, a clinical impact equivalent to adding a second drug to a pharmacological regime for diabetes." The authors concluded that larger studies need to be conducted.

A 2015 study² demonstrated significant improvement in clinical parameters of periodontal disease and glycemic control six months after nonsurgical periodontal treatment was provided. What makes this study different is that antibiotics were not used adjunctively during the treatment. The authors' rationale for providing treatment without locally applied or systemic antibiotics was to eliminate this as a variable. They point out that antibiotics, particularly systemic, can lead to controversial results regarding A1c levels, because they may affect other sources of infection in the body. If antibiotics were used, A1c improvement could not be solely attributed to reduction in the infectious and inflammatory burden from periodontal disease. The authors also stated in the introduction: "Chronic periodontal disease (CPD) and type 2 diabetes mellitus (T2DM) share common pathogenic pathways involving the cytokine network, resulting in increased susceptibility to both diseases, leading to increased inflammatory destruction, insulin resistance, and poor glycemic control."

Generalizations about the relationship between periodontal disease and diabetes cannot be drawn from two pieces of research. However, both articles make important statements about the current state of knowledge going back a number of years. The AAP/EFP workshop report had two authors and 22 collaborators. Their statement about the reduction in A1c from scaling and root planing being equivalent to adding a second oral diabetes medication speaks volumes. As important is their statement that there is a dose-dependent relationship between periodontitis and diabetes complications. That is a very bold statement. The 2015 research cited above also speaks volumes with their assumption that periodontal disease and diabetes share common pathogenic pathways. When authors of such prominence are indicating that the bidirectional relationship between periodontal disease and diabetes no longer needs proving, clinicians can take that to their patients and act on it to improve outcomes.

Another very recent development involves the action by the New Jersey State Board of Dentistry. In June, the board ruled that dentists in New Jersey can now screen at-risk patients for diabetes. The board stated that such in-office screening is within the scope of licensure in the state, but that this testing is not to be presumed to be the standard of care. This latter statement can be interpreted to mean that the screening needs to be followed by referral to a physician for definitive diagnosis. The HbA1c screening can be performed as a finger prick and analyzed in the dental office. Furthermore, an insurance carrier is launching a pilot program to enable providers to implement A1c screening. Patients generally visit their dental provider more frequently than their physician. The impact of diabetes screening and referral of patients with positive test results to their physician for management will be felt immediately for the individual and the health-care system as well. Early diagnosis is critical to the lifespan and healthspan of individuals with diabetes. Overall health-care savings should be very significant especially in view of the seriousness of the rapidly expanding number of diabetic and prediabetic individuals in the US.

These studies, among many others, and the decision by a state dental board reveal the acceptance by the dental profession of the interconnected relationship between periodontal disease and diabetes.

Source: Aurident's 3D dental scanners offer superior quality for both model and impression scanning. The Optimet DS 6000 Scanner uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans. The DSi 6000 Impression & Model Scanner overcomes the limitation of other scanners by accurately scanning impressions and models where other scanners have difficulty.

How patients make dental care purchase decisions

When patients need dentistry that requires an out-of-pocket investment, on average it takes them 69.8 days to go through a complex decision-making process before they choose to purchase recommended treatment. This was one of the key findings in the Patients' Path to Dental Care Purchase Study conducted by Rothstein Tauber on behalf of CareCredit.

The study surveyed patients who had recently made or were planning on making a dental care purchase. The study found that even though 60% of patients believed dental care to be an absolute necessity, the decision to purchase was lengthy and was influenced by cost, time, insurance benefits, and perceived need.

Not surprisingly, the majority of patients (56%) selected the dentist they already had a relationship with for the treatment they were considering, but they wanted and needed information on both the care and cost to make a decision. In fact, on their path to purchase, more patients (67%) asked about and researched cost and finances than did the treatment (58%). If the treatment was not introduced at the practice, or if the patient chose not to schedule care on the initial visit, they often went home to do more research and fact-finding. Seventy-one percent of patients who researched treatment and/or cost and financing visited a practice for information, 28% asked family and friends, and 34% sought information online. Of those going online, 51% went to a medical advice website, 38% to websites that provide reviews, and 46% to a provider's website.

The survey found 52% of patients were not aware of financing as a payment option. However, 47% of respondents who did not have CareCredit said they would consider financing through a health-care credit card like CareCredit if it enabled them to receive care right away. This option became more attractive as the cost of care increased, with 29% of all respondents indicating they would be likely or extremely likely to apply for and use CareCredit for fees of only $200. Almost half (49%) said they would be likely or extremely likely to apply for and use CareCredit for fees of $1,000. The average out-of-pocket investment for the survey participants was $1,177.80.

The survey also included patients who had previously used CareCredit to pay for health care for themselves or their families. These patients said if CareCredit had not been available they would have gone to a different provider who accepted CareCredit (29%) and/or would have chosen not to have the dentistry done (39%). There were many reasons patients found CareCredit to be useful. A vast majority (87%) said financing is a tool that helps them with unplanned healthcare expenses and 82% found CareCredit allows them to be responsive to their family's healthcare needs and not delay care.

Based on the study findings, dentists and their teams can help make patients' path to purchase easier and less stressful by having information on care, cost and all payment options, including financing, readily available and easily accessible during their treatment and fee discussion and on their web and social media sites.

Source: http://www.dentaleconomics.com/articles/print/volume-105/issue-10/practice/study-how-patients-make-dental-care-purchase-decisions.html

In other fashion news: Aurident offers the Optimet DS 6000 Scanner which uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans.

The DS 6000 Scanner can be used for all dental applications such as copings, full contour crowns, bridges up to 14 units, implants, implant bars and dentures.

SAN FRANCISCO DENTIST ACCUSED OF TRAFFICKING POT ACROSS STATE LINES

A San Francisco dentist is accused of an interstate pot operation.

Jerome Weitz, D.D.S., runs a dental practice in the city's Mission District. Prosecutors say he was trafficking marijuana from San Francisco all the way to New York.

No one, including the dentists who work at the office, told ABC7 News they had any idea the man who cuts their checks is behind bars. They also didn't know their boss' son got arrested for illegally selling medical marijuana earlier this year. Prosecutors are saying this is a case of like father, like son.

On his YouTube page Jerome Weitz is the friendly dentist his patients have known for 30 years at his Mission Street business.

"He's very open, I can have very honest conversations with him," said dentist Cecilia Cardenas, D.D.S.

New York prosecutors say the upstanding man his employees describe had a secret. Police seized 11 vacuum sealed bags of marijuana and cash from Wetiz in Yonkers, New York. Officers arrested him for running a medical marijuana trafficking business that stretched from San Francisco to New York City.

Dentist Cecelia Cardenas says her boss retired from the practice a few years ago but was an active an caring owner.

"He is the best boss I've ever worked for," Cardenas said. She added that Wetiz retired from the practice a few years ago, but that he was an active and caring owner. "It's just shocking for me."

But when you look at the documents, it doesn't seem so shocking to prosecutors who say it appears Jerome Weitz took over the illegal pot trafficking business from his son Joshua, who is now serving a one year sentence in a New York prison.

"We are encouraging cannabis uses and smokers and those who do it together to see the dentist more often," Weitz said in a YouTube video.

On his YouTube page, Weitz gave dental tips to pot patients. Now he's the one seeking pot advice, of the legal kind.

Source: http://abc7news.com/news/sf-dentist-accused-of-trafficking-pot-across-state-lines/1058759/

In other dental news: Aurident's dental 3D dental scanners offer superior quality for both model and impression scanning. The Optimet DS 6000 Scanner uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans. The DSi 6000 Impression & Model Scanner overcomes the limitation of other scanners by accurately scanning impressions and models where other scanners have difficulty.

Dentist scrutinized after child’s death

The California Dental Board is accusing a local dentist of involvement in the death of a three-year-old boy earlier this year.

A complaint filed with the Attorney General’s office by Karen M. Fischer, executive officer of the Dental Board, accuses Dr. M. Camila Borrero, DDS of gross negligence, repeated acts of negligence, incompetence and unprofessional conduct.

According to the allegation, the unidentified boy was brought in for dental treatment to Borrero’s clinic, Children’s Dental Fun Zone, 569 W. Lowell Ave., Ste. 200, on Feb. 24. The child reportedly had several cavities and needed his teeth cleaned. Borrero allegedly told his parents that the work was so extensive that she recommended sedating the boy for the procedure.

The complaint, filed on Sept. 3, states that the child was sedated at approximately 10:07 a.m. and treatment began at about 10:30 a.m. The treatment finished, according to the narrative, at about 2:30 p.m.

The child was moved to a recovery room where he was monitored until approximately 4:30 p.m., according to the complaint. At that time, Fischer writes, the boy’s heart rate began to increase and his oxygen levels dropped.

According to police dispatch logs on that day, paramedics were called to the clinic at 5:28 p.m. The boy was transferred to Sutter Tracy Community Hospital and then later than night to Kaiser Hospital in Santa Clara. The boy died in the hospital on March 1 after his parents agreed to remove him from a ventilator and he was unable to breathe on his own.

According to the complaint, Borrero administered a local anesthetic called Xylocaine and a mix of nitrous oxide and oxygen as a sedative. Borrero is accused of not recording the two times that the boy vomited during the procedure, allowing the anesthetic to wear off during the procedure and not recording his heart rate and other vital information throughout the day.

Arthur Curley, Borrero’s lawyer and a partner with firm of Bradley, Curley, Asiano, Barrabee and Kowalski of Larkspur, spoke with the Press on Thursday.

“The doctor did not do anything inappropriate that led to the child’s demise,” Curley said, adding that the Dental Board had not yet provided him with the evidence or testimony in the allegation. “We will respond appropriately to the accusation but have not seen the basis of it. Because of privacy rights. We can’t reveal any of the information that we do know.”

The complaint requests a hearing to determine whether to suspend or revoke Borrero’s dental license, suspend or revoke her permit to administer sedatives and levy possible fines.

Source: http://www.goldenstatenewspapers.com/tracy_press/news/dentist-scrutinized-after-child-s-death/article_3a0565d0-7e9d-11e5-bb82-4bcb3c075704.html

In other dental news: Aurident offers the Optimet DS 6000 Scanner which uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans.

The DS 6000 Scanner can be used for all dental applications such as copings, full contour crowns, bridges up to 14 units, implants, implant bars and dentures.

TEAM 1500 to Present "Does the Route of Dental Sedation Matter?" - A Free Teleconference

Dr. Dionne, a research professor in the School of Dental Medicine atEast Carolina University, is the co-author of Management of Pain and Anxiety in Dental Practice and has published more than 100 scientific manuscripts related to his work on pain and pain control.

Previously, Dr. Dionne served as Chief, Pain and Neurosensory Mechanism Branch at NIDCR (National Institute of Dental and Craniofacial Research) and Scientific Director at the National Institutes of Health's (NIH) National Institute of Nursing Research.

Questions surrounding the route used by dentists to sedate fearful and anxious patients – oral v. intravenous – are at the heart of a heated debate currently dividing the national dental community and members of the American Dental Association.

While some dentists contend that all routes of administration to achieve a specific level of consciousness should be treated equally, a majority of general dentists – including Dr. Dionne, cite extensive scientific and clinical evidence to support their conclusion that oral and intravenous dental sedation should not be regulated as equivalent methods.

General dentists who administer oral sedatives have treated more than 20 million dental patients in the U.S. safely, effectively, and without incident.

A controversial proposal now before the ADA's House of Delegates would require those dentists who provide oral sedation to obtain the same, rigorous and costly training that currently applies only to those dentists who are trained to use intravenous sedation in their practices. 

Critics of the ADA proposal, known as Resolution 77, contend the additional training is superfluous and does nothing to increase the safety of dental patients. To the contrary, if ADA Resolution 77 is approved, it will drive hundreds of thousands of patients away from seeing a dentist altogether because the costs of many basic sedation dentistry services will double.

Dr. Dionne will address the scientific and clinical basis for concluding that oral sedation and intravenous sedation should not be lumped together when it comes to training guidelines and regulations.

Those who register for the briefing, but are not able to participate live, will receive instructions on how to listen to a replay of the teleconference.

TEAM 1500, a coalition of more than 1,500 health care providers, opposes passage of ADA Resolution 77.  Earlier this week, TEAM 1500 published results of its ADA Resolution 77 Economic Impact Study.  The study reports that fearful and anxious dental patients who require treatments that utilize oral sedation will have to pay as much as twice current fees if ADA Resolution77 is approved.

Source: http://www.prnewswire.com/news-releases/team-1500-to-present-does-the-route-of-dental-sedation-matter---a-free-teleconference-300169344.html

In other fashion news: Aurident's 3D dental scanners offer superior quality for both model and impression scanning. The Optimet DS 6000 Scanner uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans. The DSi 6000 Impression & Model Scanner overcomes the limitation of other scanners by accurately scanning impressions and models where other scanners have difficulty.

More care, less bite: Dental discount clubs in Oregon are expanding coverage and saving patients mone

In this photo taken Wednesday, Oct. 21, 2015, Nicole Olts, a dental hygienist at PureCare Dental in Bend, Ore., works on cleaning the teeth of Dave Beach. More dentists are marketing memberships plans, in which patients pay a set annual or monthly fee, which typically covers preventive care and entitles them to discounts on other work, such as fillings and crowns . At least three independent practices in Central Oregon offer membership plans, as does PureCare Dental, with a range of discounts. (Ryan Brennecke/The Bulletin via AP)

BEND — No matter how well people take care of their teeth, things start to fall apart in old age.

Eighty-year-old Betty Williams of Redmond found that out recently when she needed a crown, a bridge and an implant. The dental work set her back about $10,000. Like more than 70 percent of the population age 65 and older, she doesn’t have private dental insurance. Medicare doesn’t cover dental care, nor is it included in the retirement benefits her husband earned as a Washington firefighter.

“It kind of hurts out-of-pocket, it really does,” Williams said.

Williams would have paid even more if she hadn’t joined her dentist’s discount club, which saved her about $3,100. Her dentist, Taylor Fowles at East Bend Dental, began offering memberships in April of 2014 after he bought the practice. Fowles said it’s been a good way to attract new patients. “It just makes sense for people that don’t have insurance,” he said.

Dentists have always had the ability to offer discounts to cash-paying customers, as long as the savings didn’t exceed insurance network discounts. In fact, Williams said she used to get a 5 percent discount from Fowles’ predecessor. But more dentists are marketing membership plans, in which patients pay a set annual or monthly fee, which typically covers preventive care and entitles them to discounts on other work, such as fillings and crowns.

At least three independent practices in Central Oregon offer membership plans, as does Willamette Dental Group, a chain with an office in Bend. The discounts that are offered range from 10 percent to 20 percent.

Access to dental care appears to be increasing because of the Affordable Care Act, according to a just-released study by the American Dental Association’s Health Policy Institute. Dentists point out that about half of Americans still lack private dental insurance. Those who offer memberships say in-house plans, which are not insurance, make care affordable and encourage people to get routine cleanings and check-ups.

“We just want them to do the preventive stuff as much as possible because it saves them so much money in the long run,” Fowles said.

Membership clubs have their advantages, but consumers also have to be aware of the limitations. The most obvious is that the membership and discount is only good at that practice, so if patients move, or switch dentists, they could lose money paid upfront.

The plans are largely unregulated, though the Oregon Insurance Division says it reviews many plans that dentists offer in order to make sure they won’t be confused with insurance. Some dentists might be required to register their plans with the state as discount medical plans, which are similar to memberships but usually involve a third party. Discerning the difference can be difficult.

“It gets complicated really quickly,” Insurance Division spokesman Jake Sunderland said. “The rule of thumb is if they’re charging for the discount, then they most likely need to be licensed.”

Sunderland said consumers should check with the state before joining a plan.

PureCare Dental in Bend was the first practice in Central Oregon to offer a membership plan, starting when the practice opened in 2010. Dentist Eric Cadwell, who ran a medical software company before going to dental school, developed the plan with his brother, who is a dentist in Washington, said Brianna Cadwell, who is married to the dentist and is the business manager. The brothers had seen other practices using them. “This is the direction dentistry is headed because dental insurance just doesn’t make sense anymore,” she said.

Many dental insurance policies have a maximum annual benefit of $1,000, so the monthly premium ends up acting like prepayment toward those benefits, Brianna Cadwell said.

PureCare’s basic membership costs $19.50 per month and includes two cleanings, exams and sets of X-rays per year, plus two emergency office visits, Cadwell said. The discount on further work is 15 percent to 20 percent, depending on the work.

While the membership fee is lower than most dental insurance premiums, the discount on major work is less than what one would receive with insurance.

People who choose to join a dentist’s membership plan instead of buying insurance can maximize their savings by paying the membership fee out of a Health Savings Account. The accounts are available to people who have high-­deductible health insurance, and they help save money on medical expenses because deposits into the account aren’t subject to federal income tax.

Sometimes it’s unclear what qualifies as a medical expense that can be paid out of an HSA. Internal Revenue Service spokesman David Tucker said dental membership fees do qualify if they cover services, rather than access to the discount.

If a dentist offers a 15 percent discount to club members on, say, a crown, and that member falls into the 15 percent federal income tax bracket and pays for the work out of an HSA, “You’re doubling your savings, really,” said Kathie Gedde, a partner at SGA Certified Public Accountants and Consultants in Bend.

PureCare has 40 percent of its patients using the membership, Cadwell said. It appeals to senior citizens and the many working adults in Central Oregon who are self-employed or work for small companies that don’t offer dental benefits, she said.

The memberships also benefit dental practices. People who join the club seem to be more diligent about taking advantage of the preventive care, Cadwell said. When patients do need work, they’re less likely to put it off because they’re not subject to annual limits or waiting periods.

“They’re not in this insurance mindset,” she said. “They’re able to dictate their care with their dental team.”

Membership plans are becoming so popular with dentists across the country that Bend resident Dan Marut stopped practicing dentistry in order to focus on his membership business, Quality Dental Plan, which now has 500 clients in 47 states. While some dentists craft their own membership plans, many turn to a company like Marut’s to help them get started and market the plan.

“Most dentists out there are solo or in small groups,” Marut said. “This is unique to our profession. We’re not only the ones performing the dentistry, we’re running the office as well.”

Dentists are more concerned about reaching people who are foregoing care than competing with insurance companies, Marut said.

“That’s our competition. Education,” he said.

People skip needed dentistry more than any other area of health care because of financial barriers, according to an annual survey by the American Dental Association. Financial barriers were more common for dentistry than any other field, which included prescriptions, eyeglasses, mental health and medicine. In 2014, 10 percent of the population did not get dental care they needed because of the cost, according to an ADA analysis of National Health Interview Survey data.

Because of the Affordable Care Act, however, those barriers are dropping across health care, including in dentistry, the ADA’s analysis said.

“The establishment of health insurance marketplaces as well as Medicaid expansion could increase dental benefits coverage and demand for dental care,” the authors concluded.

The ADA also found that in 2013, dental utilization rates were stable among working-age adults for the first time in five years. And dental care for children, who are more likely to be covered by Medicaid, reached its highest utilization rate since 1996. Not all states allow Medicaid to cover dental care, but it is included in Oregon Health Plan benefits.

More Oregonians are also covered by private insurance. Enrollment in dental-only insurance plans has risen from fewer than 700,000 people in 2011 to 1.1 million, according to the Oregon Insurance Division. That data doesn’t include dental care that’s embedded in medical insurance policies.

Coombe and Jones Dentistry in Redmond began offering a membership plan in 2010 because people were losing their jobs and employers were dropping benefits, office manager Kerrianne Bethers said. Coombe and Jones dentists were more interested in offering existing patients a way to keep up with their preventive care than marketing to new patients, Bethers said. The practice has about 200 people, or about 7 percent of its patients, enrolled in the plan, which costs $29.99 per month. (There are various prices of membership, depending on whether one needs more frequent cleanings because of gum disease.) The discount on additional work is 10 percent.

Source: http://registerguard.com/rg/business/33656009-63/more-care-less-bite-dental-discount-clubs-in-oregon-are-expanding-coverage-and-saving-patients-money.html.csp

In other dental news: Aurident offers the Optimet DS 6000 Scanner which uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans.

The DS 6000 Scanner can be used for all dental applications such as copings, full contour crowns, bridges up to 14 units, implants, implant bars and dentures.

Does state dentistry board protect dentists over the public?

In a move to protect public health, the Minnesota Board of Dentistry earlier this year considered following the example of 11 other states and establishing a system of inspections of dentists' offices. The proposed random inspections were to make sure the dentists and their staffs were following proper sanitary procedures.

Minnesota's dentists strongly opposed the plan, and the board — a majority of whose members are dentists themselves — rejected it. At the same time, dentists on the board were sharply critical of an administrator who had supported the inspections.

Minnesota dentists' offices are inspected by the state board only after someone files a complaint. That means dentists and their staffs are the only ones with the responsibility to ensure procedures are being followed to prevent infections.

Failing to follow those procedures has consequences. In 2013, more than 60 people contracted HIV and hepatitis after an oral surgeon in Oklahoma reused syringes and failed to regularly clean his instruments. The state shut down the office and revoked his license.

When the Minnesota board rejected the proposed random inspections, "I was absolutely flabbergasted," said board member Jake Manahan at a January board meeting. "I couldn't imagine why the board did not adopt some sort of an inspection program."

Manahan had proposed annual inspections of 3 percent of the state's roughly 4,000 dentists.

"I don't think a patient is in a position to sufficiently ascertain whether or not a licensee is practicing legitimate infection control," he said. "It's too subtle."

Manahan's measure faced stiff resistance from the five dentists on the nine-member board.

Board President David Gesko, dental director at HealthPartners, opposed random inspections, calling them a solution in search of a problem. During the January meeting, Gesko said the plan would cost the state too much money.

"As board members, we need to be stewards of the state and spend its money judiciously and in such a manner that it has the most value," he said. "Spending it in this way and creating staff and systems and processes and mileage to drive and do this, is not a good use of the state's resources."

The motion's defeat came after several hours of debate. All five dentists on the board voted against it. The two citizen board members and two others, a dental assistant and a dental hygienist, voted for it.

The vote was a victory for the Minnesota Dental Association, which had lobbied against random inspections.

But the vote and the way some members treated the board's longtime executive director have at least one legislator concerned.

Sen. Tony Lourey, DFL-Kerrick, chair of the Senate Health and Human Services Finance Committee, said he's worried dentists on the board are more concerned about protecting their interests than protecting the public.

"I think that we do need to take a very close look at whether the dentists are voting as a block to avoid this random inspection," Lourey said. "We probably need to ask why. And ask whether this board is meeting their objective."

Lourey said he may hold hearings on whether the board needs to be reconstituted to ensure that dentists can't block policy. He also expressed concern about how David Gesko and Neal Benjamin, a fellow dentist on the board, openly criticized the board's executive director, Marshall Shragg, who supported random inspections.

At meetings in January and February, Gesko and Benjamin pushed to review Shragg's job performance in open meetings. Even after other board members expressed surprise and dismay about discussing Shragg's personnel records in public, Gesko continued to push for it.

The five dentists on the board voted against random inspections. The four non-dentists voted in favor. Amanda Snyder | MPR News file

Citing concerns over confidentiality, the board eventually voted against holding the review in February.

Benjamin didn't respond to repeated interview requests. Gesko, in an emailed reply to an interview request, wrote that the board decided not to order random inspections only after consulting several national experts. His email did not mention Marshall Shragg.

Privately, there were signs they weren't happy with Shragg or anyone else supporting random inspections.

In an email obtained by MPR News, Benjamin expressed his unhappiness with backers of random inspections.

He wrote to a member of the Minnesota Dental Association that they should "gather and throw out the tyrants who might choose to build a punitive system of oppressive control rather than develop an ethical environment of discussion and support."

Sen. Lourey said it looks as if dentists on the board retaliated against Shragg.

"I do have some concerns," he said. "The sequence of events does look a little suspicious, but I try not to rush to judgment."

Shragg left his position in April and declined to comment for this report. No member of the board would agree to an interview. A few cited board policy that only the board president and executive director can speak to reporters.

Gesko's email said a task force has been formed to study the infection-control issue.

One state that does conduct random dental office inspections is Ohio. Harry Kamdar, executive director of Ohio's Board of Dentistry, said Minnesota's board should consider the practice.

"This is not just about protecting dentists," he said. "This is about protecting the public. That should be the first and foremost duty of the board."

It's not clear when the Minnesota Dental Board task force will make recommendations about infection control.

Correction (Oct. 30, 2015): An earlier version of this story incorrectly said a dental therapist voted for the plan. It was a dental assistant.

Source: http://www.mprnews.org/story/2015/10/30/state-dentistry-board

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UAB's free dental event draws more than 500 patients

Dentists probably pulled at least 600 teeth at UAB's Community Day on Thursday, said Dentistry School Dean Michael Reddy, and three of them belonged to Meade Frierson.

Frierson had two roots and one tooth pulled during the event, where volunteers and students come together to provide free dental care to people with limited incomes and no insurance. Dentists offered basic services such as cleanings, fillings and extractions at UAB and two other locations. Many of those who visited the clinic came to have teeth removed, Reddy said.

Frierson lives in a shelter and hadn't seen a dentist since 1997. Although his teeth hadn't been causing him any pain, the broken teeth created other problems.

The extractions will allow him to get fitted for dentures, Frierson said. Over the years, he has lost so many teeth he can barely eat solid food.

"I have one tooth I can chew with," he said. "With the dentures, I'll be able to chew again."

Throughout the day, students at UAB's Dental School worked alongside faculty members and dentists from the community to clean, remove or fill the teeth of about 550 patients at all three sites.

Vans and buses delivered patients from shelters and churches.

People came from as far away as Uniontown in Marengo County, including Clementine Turner, 60, who woke at 5:45 a.m. to catch the bus to UAB.

"I have one tooth I can chew with," he said.

Turner walked through a welcome tent erected in the middle of 7^thAve. South at about 10:30 a.m., then passed into the lobby of the dental school. She received a numbered folder and moved to the waiting room.

First she stopped at triage, where second-year dental student Mac Hendrix took her blood pressure, health history and checked her teeth.

"Are you having any pain?" Hendrix asked.

"No, everything feels good," Turner said.

But the student found two trouble spots – softness and decay in a couple of teeth that would probably require fillings.

After supervising dentist Dr. Diane Feagin confirmed the diagnosis, the pair sent Turner to have an X-ray.

Turner had four teeth pulled during last year's Community Day, but this year, dentists felt they could save both teeth. After her X-ray, Turner went upstairs to restoration – where patients waited in chairs amid the background hum of dental drills.

After about an hour wait, Dr. James Sanderson settled Turner in a chair and quickly went to work, drawing up a dose of lidocaine to numb her teeth. Sanderson has a practice in Hoover, but has volunteered at Community Day in all three years since it started.

Dr. Conan Davis, a professor at the dental school and Chair of UAB Dentistry Cares, said the event not only provides dental care for adults in need – it also raises awareness of the lack of resources for low-income adults. Alabama is one of just six states that provide no dental coverage for adults on Medicaid, according to the National Academy for State Health Policy.

Although there are a handful of clinics that provide low-cost dental care, there are not enough resources for adults who can't afford dental care, Davis said.

"We know there are associations between things like periodontal disease and heart disease," Davis said. "It can impact health in a lot of ways."

Turner suffered for years with pain in her teeth, but couldn't afford to pay $175 per tooth to have them pulled by a dentist in Uniontown. She hadn't seen a dentist in 10 years when she arrived at Community Day last year.

Edwina Taylor runs a low-cost dental clinic on the weekends for Cahaba Valley Health Care. She has met patients who have been to the ER several times with abscessed teeth, but no means to pay for their removal. At least one of them made an appointment at Community Day to have his bad tooth checked and pulled, she said.

"There are people who have been waiting for years to get their teeth fixed," Taylor said.

Turner said she struggled with dental problems for years before she came to UAB last year. Instead of being nervous at the prospect of having her teeth pulled, she was excited.

"I was relaxed," she said, "because I was so excited to get it over with."

Source: http://www.al.com/news/birmingham/index.ssf/2015/10/uabs_free_dental_event_draws_m.html

In other dental news: Aurident offers the Optimet DS 6000 Scanner which uses patented proprietary conoscopic holographic technology to generate highly accurate and consistent scans.

The DS 6000 Scanner can be used for all dental applications such as copings, full contour crowns, bridges up to 14 units, implants, implant bars and dentures.