Covering the debate over expanded use of dental therapists [news release]
Reminds me of my sister who is a pharmacist. She goes on yearly medical missions to Haiti. The folks working in the pharmacy at the clinic there have only a high school education. My sister is a stickler when it comes to pharmacy practice/licensing in the US. But very much in awe with her Haitian colleagues and what they know and are able to do.
From the 10 March 2016 item at Covering Health:Monitoring the Pulse of Health Care Journalism
Excerpts
A recent news package in The Seattle Times by reporter Will Drabold took a look at how the controversy over dental therapists is unfolding in the state of Washington.
Drabold examined the challenges faced by poor Medicaid patients in seeking dental care. He spoke with health care advocates who believe that technically-trained mid-level providers could bring much-needed care to poor and isolated communities. He also interviewed tribal leader Brian Cladoosby, whose Swinomish tribe had just defied state restrictions to hire a dental therapist. And he spoke with state dental association officials, who made it clear that they – like the American Dental Association – believe dental therapists lack the training to perform these expanded duties.
Dental therapists, who often are compared to nurse practitioners, are trained to deliver a range of services including screenings, cleanings, preventive care, fillings and extractions. While the therapists do work under the supervision of dentists, dental groups often contend that dentists alone have the training to perform what they consider irreversible surgical procedures, such as drilling and extracting teeth.
In spite of resistance from organized dentistry, variations of the therapist model already are being used in Alaska’s tribal lands and in the state of Minnesota. Dental therapists have been approved in Maine and are being considered in a number of other states.
Study: Providing dental insurance not enough to induce americans to seek care
Study: Providing dental insurance not enough to induce americans to seek care.
Providing people with dental insurance does not necessarily mean that they will use it and seek dental care, according to a new study from the University of Maryland School of Dentistry, published online in the American Journal of Public Health. The research suggests that outreach and education are needed to ensure that people value their dental health and use their coverage to seek appropriate dental care. The study has particular value in this era of health reform, and the researchers hope that policymakers will use the findings in designing future programs and initiatives, according to first author Richard J. Manski, DDS, MBA, PhD, professor and chief of Dental Public Health at the University of Maryland School of Dentistry.
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Dental Care Coverage and Use: Modeling Limitations and Opportunities | Full Text Reports…
Dental Care Coverage and Use: Modeling Limitations and Opportunities | Full Text Reports….
January 17, 2014Source: American Journal of Public Health
Objectives.
We examined why older US adults without dental care coverage and use would have lower use rates if offered coverage than do those who currently have coverage.Methods.
We used data from the 2008 Health and Retirement Study to estimate a multinomial logistic model to analyze the influence of personal characteristics in the grouping of older US adults into those with and those without dental care coverage and dental care use.Results.
Compared with persons with no coverage and no dental care use, users of dental care with coverage were more likely to be younger, female, wealthier, college graduates, married, in excellent or very good health, and not missing all their permanent teeth.Conclusions.
Providing dental care coverage to uninsured older US adults without use will not necessarily result in use rates similar to those with prior coverage and use. We have offered a model using modifiable factors that may help policy planners facilitate programs to increase dental care coverage uptake and use.
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Think before you drink: Erosion of tooth enamel from soda pop is permanent
From the 24 July 2013 article at Medical News Today
You may be saving calories by drinking diet soda, but when it comes to enamel erosion of your teeth, it’s no better than regular soda.
In the last 25 years, Kim McFarland, D.D.S., associate professor in the University of Nebraska Medical Center College of Dentistry in Lincoln, has seen an increase in the number of dental patients with erosion of the tooth enamel – the protective layer of the tooth. Once erosion occurs, it can’t be reversed and affects people their whole life.
“I’d see erosion once in a while 25 years ago but I see much more prevalence nowadays,” Dr. McFarland said. “A lot of young people drink massive quantities of soda. It’s no surprise we’re seeing more sensitivity.”
Triggers like hot and cold drinks – and even cold air – reach the tooth’s nerve and cause pain. Depending on the frequency and amount of soda consumed, the erosion process can be extreme.
…
Dr. McFarland said it’s best not to drink soda at all, but she offers tips for those who continue to drink it.
- Limit consumption of soda to meal time
- Don’t drink soda throughout the day
- Brush your teeth afterwards — toothpaste re-mineralizes or strengthens areas where acid weakened the teeth
- If tooth brushing is not possible, at least rinse out your mouth with water
- Chew sugar free gum or better yet, gum containing Xylitol.
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- UNMC warns erosion of tooth enamel from soda is permanent (nebraskaradionetwork.com)
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Dentists suggest alternative to candy…..Trick or Treat!
From the blog of George Namay DDS [posting here does not constitute endorsement of his services]
Worried about the effect of trick-or-treating candy on kids’ teeth, dentists are encouraging parents to offer a sugar-free alternative instead: coupons for the “Plants vs. Zombies” video game. The following column from the West Michigan District Dental Society explains how the “Stop Zombie Mouth” campaign works:
The zombies are here! Just in time for Halloween, the American Dental Association’s “Stop Zombie Mouth” campaign is redefining what a Halloween “treat” can be by offering fun instead of candy.
The ADA is partnering with PopCap Games, makers of the popular “Plants vs. Zombies” video game, for the campaign to raise awareness of oral health while offering a fun alternative to sugary treats.
Now through Halloween, the “Stop Zombie Campaign” will feature PopCap’s family-friendly video game, Plants vs. Zombies, as a tooth-friendly alternative to candy. PopCap will give away millions of copies of the game, more than 1 million free packs of game-inspired trading cards and other themed items with tips to keep teeth healthy.
One Step Closer to Growing a Tooth

Diseases and conditions where stem cell treatment is promising or emerging. (See Wikipedia:Stem cell#Treatments). Bone marrow transplantation is, as of 2009, the only established use of stem cells. Model: Mikael Häggström. To discuss image, please see Template talk:Häggström diagrams (Photo credit: Wikipedia)
From the 20 July 2012 article at Science News Daily
To build a tooth, a detailed recipe to instruct cells to differentiate towards proper lineages and form dental cells is needed. Researchers in the group of Professor Irma Thesleff at the Institute of Biotechnology in Helsinki, Finland have now found a marker for dental stem cells. They showed that the transcription factor Sox2 is specifically expressed in stem cells of the mouse front tooth…
..
Despite the development of new bioengineering protocols, building a tooth from stem cells remains a distant goal. Demand for it exists as loss of teeth affects oral health, quality of life, as well as one’s appearance. To build a tooth, a detailed recipe to instruct cells to differentiate towards proper lineages and form dental cells is needed. However, the study of stem cells requires their isolation and a lack of a specific marker has hindered studies so far.
Researchers in the group of Professor Irma Thesleff at the Institute of Biotechnology in Helsinki, Finland have now found a marker for dental stem cells. They showed that the transcription factor Sox2 is specifically expressed in stem cells of the mouse incisor (front tooth). The mouse incisor grows continuously throughout life and this growth is fueled by stem cells located at the base of the tooth. These cells offer an excellent model to study dental stem cells.
The researchers developed a method to record the division, movement, and specification of these cells. By tracing the descendants of genetically labeled cells, they also showed that Sox2 positive stem cells give rise to enamel-forming ameloblasts as well as other cell lineages of the tooth.
– Although human teeth don’t grow continuously, the mechanisms that control and regulate their growth are similar as in mouse teeth…
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Dental Fillings That Kill Bacteria and Re-Mineralize the Tooth
From the 26 April Science Daily article
ScienceDaily (May 1, 2012) — Scientists using nanotechology at the University of Maryland School of Dentistry have created the first cavity-filling composite that kills harmful bacteria and regenerates tooth structure lost to bacterial decay.
Rather than just limiting decay with conventional fillings, the new composite is a revolutionary dental weapon to control harmful bacteria, which co-exist in the natural colony of microorganisms in the mouth, says professor Huakun (Hockin) Xu, PhD, MS.
“Tooth decay means that the mineral content in the tooth has been dissolved by the organic acids secreted by bacteria residing in biofilms or plaques on the tooth surface. These organisms convert carbohydrates to acids that decrease the minerals in the tooth structure,” says Xu, director of the Division of Biomaterials and Tissue Engineering in the School’s Department of Endodontics, Prosthodontics and Operative Dentistry…..
No Proof Found That Gum Disease Causes Heart Disease or Stroke
(I will continue to floss, tho, for the sake of my gums. However it is a relief to know there is one less thing to think about when it comes to heart health)
From the 18th April 2012 article at Science Daily article
Despite popular belief, gum disease hasn’t been proven to cause atherosclerotic heart disease or stroke, and treating gum disease hasn’t been proven to prevent heart disease or stroke, according to a new scientific statement published in Circulation, an American Heart Association journal.
Keeping teeth and gums healthy is important for your overall health. However, an American Heart Association expert committee — made up of cardiologists, dentists and infectious diseases specialists — found no conclusive scientific evidence that gum disease, also known as periodontal disease, causes or increases the rates of cardiovascular diseases. Current data don’t indicate whether regular brushing and flossing or treatment of gum disease can cut the incidence of atherosclerosis, the narrowing of the arteries that can cause heart attacks and strokes.
Observational studies have noted associations between gum disease and cardiovascular disease, but the 500 journal articles and studies reviewed by the committee didn’t confirm a causative link.
“There’s a lot of confusion out there,” said Peter Lockhart, D.D.S., co-chair of the statement writing group and professor and chair of oral medicine at the Carolinas Medical Center in Charlotte, N.C. “The message sent out by some in healthcare professions that heart attack and stroke are directly linked to gum disease, can distort the facts, alarm patients and perhaps shift the focus on prevention away from well known risk factors for these diseases.”
Gum disease and cardiovascular disease both produce markers of inflammation such as C-reactive protein, and share other common risk factors as well, including cigarette smoking, age and diabetes mellitus . These common factors may help explain why diseases of the blood vessels and mouth occur in tandem. Although several studies appeared to show a stronger relationship between these diseases, in those studies researchers didn’t account for the risk factors common to both diseases….
…
“We already know that some people are less proactive about their cardiovascular health than others. Individuals who do not pay attention to the very powerful and well proven risk factors, like smoking, diabetes or high blood pressure, may not pay close attention to their oral health either” Lockhart said. [Janice’s emphasis]
Statements that imply a cause and effect relationship between periodontal disease and cardiovascular disease, or claim that dental treatment may prevent heart attack or stroke are “unwarranted,” at this time, the statement authors said.
The American Dental Association Council on Scientific Affairs agrees with the conclusions of this report. The statement has been endorsed by the World Heart Federation.
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Dentists Could Screen 20 Million Americans For Chronic Physical Illnesses
From a December 2011 press release of New York University
An Opportunity to Identify Diabetes, Hypertension, and Other Chronic Diseases
Nearly 20 million Americans annually visit a dentist but not a general healthcare provider, according to an NYU study published today in the American Journal of Public Health.
The study, conducted by a nursing-dental research team at NYU, is the first of its kind to determine the proportion of Americans who are seen annually by a dentist but not by a general healthcare provider.
This finding suggests dentists can play a crucial role as health care practitioners in the front-line defense of identifying systemic disease which would otherwise go undetected in a significant portion of the population, say the researchers.
“For these and other individuals, dental professionals are in a key position to assess and detect oral signs and symptoms of systemic health disorders that may otherwise go unnoticed, and to refer patients for follow-up care,” said Dr. Shiela Strauss, an associate professor of nursing at the NYU College of Nursing and co-director of the statistics and data management core for NYU’s Colleges of Nursing and Dentistry.
During the course of a routine dental examination, dentists and dental hygienists, as trained healthcare providers, can take a patient’s health history, check blood pressure, and use direct clinical observation and X-rays to detect risk for systemic conditions, such as diabetes, hypertension, and heart disease. ……
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Are Dentists Overtreating Your Teeth?
From the 28 November New York Times article
By TARA PARKER-POPEHave you had a rash of fillings after years of healthy teeth? The culprit may be “microcavities,” and not every dentist thinks they need to be treated, reports today’s Science Times.
With increasingly sophisticated detection technology, dentists are finding — and treating — tooth abnormalities that may or may not develop into cavities. While some describe their efforts as a proactive strategy to protect patients from harm, critics say the procedures are unnecessary and painful, and are driving up the costs of care.
“A better approach is watchful waiting,” said Dr. James Bader, a research professor at the University of North Carolina School of Dentistry. “Examine it again in six months.”
To learn more about microcavities, read the full article, “A Closer Look at Teeth May Mean More Filling,” and then please join the discussion below.
Related Resources
- Dental Health (MedlinePlus) has links to great resources with overviews and information on treatments, prevention/screening, specific conditions, and more
- WebMD Oral Health includes news, resources, guides, and information on treatments
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Your Mouth is a Health Barometer
Health Tip: Your Mouth is a Health Barometer
Oral problems may be tied to other medical issues
Oral health problems, such as gum disease or mouth sores, can be related to other health issues.
The womenshealth.gov Web site says these health conditions often are related to oral health problems:
- Cancer treatments, which can cause mouth sores and mouth pain.
- Diabetes, which can affect the gums.
- HIV, which can cause pain in the mouth and loss of taste.
- Nutritional deficiencies, as difficulty eating can lead to malnutrition.
- Heart disease patients may require special precautions, such as taking an antibiotic to prevent infection before a dental procedure.