The American Dental Association (ADA) recently released its inaugural “Action for Dental Health: Report to Congress” which recognizes the one-year anniversary of the launch of the Action for Dental Health (ADH) movement and grassroots efforts to eliminate barriers to dental health across the country.
The report was released during the ADA’s annual Washington Leadership Conference where more than 500 dentists from across the country meet with their Congressional delegations to discuss policy issues to improve our nation’s dental health.
“Millions of Americans continue to face barriers to dental care, which is why the ADA launched Action for Dental Health,” said ADA President Charles Norman. “This Report to Congress serves as a continued call to action for elected officials, health policy organizations, community leaders and the dental community to come together to bridge the dental divide.”
Much attention has been paid to the political debate around the Affordable Care Act, while the need for greater access to dental care has been ignored. The ADA report sits several statistics:
- This year alone, more than 181 million Americans won’t visit a dentist
- Nearly half of people over 30 suffer from some form of gum disease
- Nearly one in four children under the age of five already have cavities
- Nationally, more than 2.1 million people showed up in emergency rooms with dental pain in 2010 – that’s double the number just a decade prior.
In response, the ADA created Action for Dental Health, a nationwide, community-based movement to address barriers to dental health through sustainable solutions that provide the best quality of care. ADA reports that Action for Dental Health has already taken root in every state across the U.S.
The report outlines four key strategies:
- Providing care now. This includes hospital emergency room referral programs to connect patients in pain to dentists who can provide needed treatment, and expanding programs like Give Kids a Smile.
- Strengthening and expanding the public/private safety net by fighting for increased dental health protections under Medicaid and helping more dentists work with community health centers and clinics.
- Bringing disease prevention and education into communities through Community Dental Health Coordinators (CDHCs) who provide dental health education and help people in underserved areas connect to community health resources and dentists for needed treatment.
- Working to pass Legislation at the federal and state levels that support Action for Dental Health initiatives.
The ADA has set bold goals for Action for Dental Health. These include:
- Creating ER interception programs to reduce the burden on our nation’s emergency rooms and improving dental health in 25 states by 2015, and 50 states and the District of Columbia by 2020.
- Training at least 1,000 dentists to provide care in nursing homes by 2020, and increasing the number of dentists serving on advisory boards or as dental directors of long-term care facilities
- Expanding programs which provide screening and treatment to help people in need connect with dentists for continuity of care and work to eliminate cavities in children under five in the U.S. by 2020
- Improving the existing safety net and helping people connect with community resources and dentists by increasing the number of states with active Community Dental Health Coordinators to 15 states by 2015 (Currently there are CDHCs in 8 states.)
- Reducing the proportion of both adults and children under 18 with untreated dental decay by 15 percent by 2020
- Increasing the proportion of low income children who received any preventive dental services during the past year by 15 percent by 2020.
To review detailed goals for Action for Dental Health, or to download the “Action for Dental Health: Report to Congress” visit ADA.org/action.
access to care
Screenings by dentists for the most common chronic medical diseases could save the American health care system as much as $102.6 million annually, according to a new study conducted by the American Dental Association's Health Policy Resources Center (HPRC).
The findings were published Feb. 13 in the American Journal of Public Health.
According to the Centers for Disease Control and Prevention, 7.8 percent of the U.S. population has undiagnosed hypertension, 2.7 percent has undiagnosed diabetes and 8.2 percent has undiagnosed high cholesterol. Screening for these conditions in dental offices could lead to savings of up to $102.6 million, or $33 per person screened, and healthier outcomes for patients.
“As many as 27 million people visit a dentist but not a physician in a given year,” Kamyar Nasseh, PhD, lead author of the study said in a prepared release. “This presents an opportunity for dentists to be part of an integrated health care team working to combat chronic illnesses.”
There is potential for additional savings over the long term through prevention, health promotion, and early interventions that the study did not model.
“We have long known that the mouth is the window to the body,” said ADA President Charles H. Norman.“But we have an increased understanding about roles that dentists can play in detecting chronic, systemic disease. This study shows that dentists can contribute to reduced health care costs in the U.S. by screening for chronic conditions.”
According to the Centers for Disease Control and Prevention, about half of all American adults suffer from chronic illnesses, which account for more than 75 percent of health care costs and 70 percent of deaths each year in the United States. Chronic diseases are estimated to cost the country $153 billion annually in lost productivity.
Midwestern University’s Dental Institute recently announced the addition of pediatric dental care — exams, cleanings, tooth restoration, and minor oral surgery — for children from age 5 and up. Orthodontic care is also available. Since some children can benefit from early orthodontic intervention, the Dental Institute strongly advises an orthodontic screening by age 7.
The Dental Institute is home to some of the most advanced technology and diagnostic tools available to help provide patients with quality dental care. Student dentists in their final years of professional training treat patients under the supervision of licensed faculty who have many years of private practice experience. As a teaching clinic, patients can expect comprehensive, compassionate care – at about half the cost.
The Dental Institute is part of Midwestern University’s Multispecialty Clinic located at 3450 Lacey Road, Downers Grove IL. For more information about the services offered at the Dental Institute, contact 630.743.4500 or visit www.mwuclincs.com.
access to care
It’s back to school time – which means that a fast breakfast of cold cereal before a mad dash to the bus stop will return to many of your patients’ routines.
They might be interested to know that a glass of milk after eating sugary cereals may prevent cavities, according to new research from the University of Illinois at Chicago College of Dentistry. The research is published in the July issue of the Journal of The American Dental Association.
Dry ready-to-eat, sugar-added cereals combine refined sugar and starch. When those carbohydrates are consumed, bacteria in the dental plaque on tooth surfaces produce acids, said Christine Wu, professor of pediatric dentistry and director of cariology, who served as principal investigator of the study. Reports have shown that eating carbohydrates four times daily, or in quantities greater than 60 grams per person per day, increases the risk of cavities.
The new study involved 20 adults eating 20 grams of dry Froot Loops cereal, then drinking different beverages: whole milk, 100 percent apple juice, or tap water.
"Our study results show that only milk was able to reduce acidity of dental plaque resulting from consuming sugary Froot Loops," the researchers reported. "We believe that milk helped mitigate the damaging effect of fermentable carbohydrate and overcome the previously lowered plaque pH."
Dr. Wu said many consumers think that since milk is considered to be cavity-fighting, acid production by plaque bacteria can be minimized by mixing it with cereal. However, in an unpublished study in her lab, it was discovered that the combination of Froot Loops and milk became syrupy. Eating cereal combined with milk lowered plaque acidity to levels similar to that obtained after rinsing with a 10 percent sugar solution.
The following editorial regarding Incurred Medical Expense (IME) appeared in the Jan/Feb 2013 issue of the CDS Review.
Penny wise, pound foolish
By Walter F. Lamacki, DDS
Editor, CDS Review
In June, Gov. Pat Quinn signed legislation extracting $2.7 billion from the state’s $14 billion Medicaid program, ostensibly to save the program. One of the changes is the elimination of coverage for adult dental care, a bankrupt idea that former Gov. Jim Edgar tried in the 1990s and had to abandon when emergency room costs skyrocketed, thus eliminating any phantom savings. The $51 million adult dental program represents about 2 percent of the cuts. A 2005 study by the Kaiser Foundation concluded that any savings from the elimination of adult care are miniscule.
While one door slammed shut another opened a crack for those, I believe, to be the most underserved population of patients: those 100,000 residents living in nursing homes in Illinois. Up until now, those who received care under Medicaid were treated by volunteers and a few Medicaid providers on a hit or miss basis — miss being the operative word. But a quirk in the maze of federal regulations can increase access to care for this neglected patient pool.
Incurred Medical Expense (IME), until now an obscure provision of the Medicare/Medicaid regulations, can help many residents of nursing homes receive necessary dental care. The resident must be enrolled in Medicaid and have some income, usually Social Security. Typically residents assign their Social Security payments to the facility to pay for their monthly fees. However, they do not relinquish total control of their Social Security checks. When a resident with Medicaid receives a bill for services not offered by the facility, they may qualify for IME. They can elect to apply their Social Security checks to pay their dental bills. In most cases, the dentists will be paid their usual and customary fees. Medicare then will reimburse the nursing home for the lost income. Most states do not require pre-treatment authorization.
Please visit www.ada.org for a more detailed explanation of IME and the steps dentists must take to receive payment for their services. We don’t know — at this time — what changes, if any, the Affordable Care Act will bring, but my guess is some similar program will be in place.
If you chose to take care of nursing home residents (and I hope you will), your treatment presents a whole new perspective. Patients can have diabetes, chronic heart failure and other chronic conditions. The most difficult condition you will face is varying degrees of dementia and its big brother, Alzheimer’s disease. As Shakespeare’s Hamlet tells us, “Old men are twice children;” compassion and patience will be valuable tools in your armamentarium.
You won’t have pretty pictures of your patient’s mouth, with a dozen pearly white porcelain veneers made possible by your persuasive skills. Many of the residents have outlived their closest relatives and seem to be warehoused out of sight and mostly forgotten. Improving the quality of their lives and giving them back their dignity will enrich you immeasurably.
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access to care
health care reform