Here are some low cost/sliding scale dental care options in the south suburbs. A sliding scale offers patients fees that reflect their income level.

Will County Community Health Center

1106 Neal Ave., Joliet

Phone: 815-774-7300

www.willcountyhealth.org

(A division of the Will County Health Department)

Contact: Rita Giannattasio, director of health promotions

Hours: 7:30 a.m. to 4:30 p.m. Monday-Wednesday, 7:30 a.m. to 7:30 p.m. Thursday, 7:30 a.m. to 2 p.m. Friday, 7:30 a.m. to 3 p.m. Saturday.

Dental services provided: complete oral exams, school exams, fluoride treatments, dental sealants, fillings, cleanings and extractions. Services are available to the center’s medical patients only and are by appointment only.

Charges for dental services are based on a sliding scale with proof of income. Services are available for children and adults but are mainly targeted toward children. Patients are accepted from throughout the area; residence in Will County is not required.

Will-Grundy Medical Clinic

213 E. Cass St., Joliet

815-726-3377

www.wgmedclinic.org

Contact: J.D. Ross, executive director

Hours: 8:30 a.m. to 4 p.m. (closed for lunch) Monday-Friday.

Services offered: Limited dental services, mostly extractions and filings. Some specialized work depending on the patient (i.e. cleanings for diabetics, etc.).

Qualifications: Must apply to be a patient. Once a patient qualifies, clinic will provide basic dental needs. Services are available to people without insurance or those whose injuries or conditions are not covered by other sources (i.e. a legal settlement or worker’s compensation claim) Must be a resident of Will or Grundy Counties.

Credit: Chicago Tribune

A little toothache can pretty quickly turn into a big headache -not just for your mouth but for your wallet too. That’s why CIGNA’s new series of dental HMO plans places an even greater emphasis on affordability and promoting wellness by covering more preventive dental care services (see also CIGNA).

For example, under the new plans, up to four routine cleanings a year – two at no cost and two for a minimal copay — are covered when recommended by the dentist. Children are covered for two fluoride treatments a year to help prevent tooth decay, one of the most common chronic infectious diseases among U.S. children1.

“If you have dental insurance, you might pay nothing or very little out of your pocket for a routine dental visit (cleaning, x-rays and exam), compared with an average of $150 or more if you don’t have coverage,” said Dr. Miles Hall, chief dental clinical director for CIGNA*. “If you need to have a cavity filled, on average the cost would be $115 or more without insurance compared to low or no cost with our dental HMO plan. Waiting too long to treat a small cavity could mean you’d pay many times more for more costly dental procedures, such as a root canal, and spend more time away from work and personal life to recover. The key message we’re sending with the new plan designs is ‘prevention matters, so don’t wait.’”

Hall said CIGNA is also changing some aspects of plan rules to make it easier for people to schedule their preventive dental care. Under the new plans, which are available now, the company is doing away with the requirement that cleanings be done at least six months apart.

In addition, the new plans cover teeth whitening – the kind of gel bleaching with take-home trays that many dentists offer. The plans continue to include important preventive features such as no age limitation on sealants, no referrals needed for orthodontic care, no referrals needed for care by a network pediatric dentist for children under 7, and coverage for procedures to help detect oral cancer early.

According to Bebe Shuler-Mure, assistant vice president of product for CIGNA’s dental products, CIGNA has been working to broaden the network of dentists who participate in the dental HMO plan and now has over 13,600 unique dentists who practice among over 43,500 office locations in the network, one of the largest dental HMO networks in the country. Individuals can locate an in-network dentist using the dental directory on www.cigna.com.

At a time when the affordability of coverage is a concern for both employees and employers, the new plans are offered with a range of benefit and copay options.

“CIGNA’s new dental HMO plans have more options available than many other carriers, including standard plans, plans with and without orthodontia coverage, specialty dental care discount, and split copay plans where copays are lower for using a general dentist and higher for dental specialty care,” said Shuler-Mure. “This array of options gives employers flexibility to continue to provide a dental plan, even if their benefits budgets are under strain due to the economic downturn. The plans are also available on what is known as a voluntary (employee-paid) basis, where employees can get the advantage of obtaining insurance at lower, group rates.”

CIGNA is also using its diverse product capabilities to provide value-added services for people in its dental plans coupon. CIGNA will offer identity theft resolution services free of charge for individuals covered under the new series of dental HMO plans. Someone who falls victim to identify theft can be guided through the steps to recovery by an identify theft expert, 24 hours a day, 7 days a week, at no charge.

A Big Dir

To say Americans are feeling lousy about their retirement prospects is a huge understatement. They’re feeling downright hopeless. Only 13 percent of adults over 25 are certain they’ll be able to live comfortably in their later years, according to a recent survey by the Employee Benefit Research Institute. That’s the lowest level of confidence reported since the annual survey began in 1993. And who can blame these dejected retirement savers? The majority of would-be retirees have watched their nest eggs crumble in the market’s undoing, and few have the cushion of a traditional pension.

But this widespread pessimism could have a slight upside, says Jack VanDerhei, research director for EBRI. “There was so much unwarranted optimism going into this that people have a much more realistic outlook now,” he says. “You may never have been on target even before you had the kind of losses many people incurred last year in the stock market.” The bottom line: If stocks return to their prerecession highs in the near future, traditional retirement will still be tough. That’s because would-be retirees are also facing the threat of rising inflation, ballooning dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>healthcare costs, the possibility of outliving their money, and the prospect of another big market drop. Here are some ways to prepare for these challenges:

Inflation. Some experts say inflation could diminish your purchasing power even more in the future than it does today, largely because of America’s ever increasing national debt. One way to guard your portfolio against inflation is by mixing in more asset classes–especially those that don’t move in step with the overall market. “Stocks, commodities, and real estate exposure all hedge against inflation really well,” says Frank Armstrong, founder of Investor Solutions and coauthor of Save Your Retirement: What to Do If You Haven’t Saved Enough or If Your Investments Were Devastated by the Market Meltdown . Financial planners vary widely in their opinions about the most sensible allocation to stocks in a retiree’s portfolio. “If you are in your mid-to-late 60s and in reasonably good dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>health and have every prospect of living into your 90s, you might want to keep anywhere from 35 to 50 percent in equities,” says Jerry Miccolis, a certified financial planner for Brinton Eaton Wealth Advisors and coauthor of Asset Allocation for Dummies. “But if you’re in your mid-70s and in failing dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>health and this portfolio is really all you’ve got–and your investment horizon isn’t that long–you ought to have a third or less in equities.”

But some planners think stocks–even when used as an inflation-fighter–are just too risky. Instead, they point to treasury inflation-protected securities, which are government bonds that guarantee a rate of return above inflation. The downside is that investors trade the prospect of high returns for that safety. “I think it makes sense to hold a substantial portion of your portfolio in TIPS,” says Olivia Mitchell, director of the Boettner Center for Pensions and Retirement Research at the University of Pennsylvania’s Wharton School. “You might not make a lot of money, but you won’t lose any money.”

Outliving your money. Once Americans make it to age 65, men can expect to live an additional 17 years and women can expect to live 20 more years. Advances in dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>healthcare could stretch that timeline. Traditional pension plans, Social Security, and annuities all offer protection against the threat of outliving your assets because the payouts last as long as you live. Social Security recipients even have annual cost-of-living increases, which are tied to the consumer price index. Social Security payouts also rise by approximately 7 to 8 percent for each year you delay claiming between ages 62 and 70. That’s enough of an incentive for Bill Russell, 62, to delay claiming until he’s 66–his full retirement age–to get a higher benefit amount for himself and his wife. “If I should die between now and when I start drawing, I want to maximize my wife’s Social Security benefit,” says Russell, who lives in Branson, Mo. Spouses are eligible for 50 percent of the higher earner’s due if that’s more than the amount that can be claimed based on their working record. If either spouse claims Social Security before full retirement age, the checks are smaller.

Working longer is the quickest way to pad a retirement account and decrease the number of years over which your savings must be spread. “Retiring early is just not reasonable for the vast majority of people at 55,” says Joshua Itzoe, a certified financial planner, principal at Greenspring Wealth Management, and the author of Fixing the 401(k) . “If you work 35 years–and let’s assume you live to be 95–you are in retirement longer than you were in the workforce, and that’s not feasible.” About 72 percent of Americans expect to work after they officially retire, according to the Employee Benefit Research Institute, up from 63 percent in 2008. “If you are already 55 or older and $50,000 is all you have saved for retirement, I think the only option you have is to try to push back your retirement age,” says VanDerhei. “Never retire until you are sure you have enough money, because it is going to be very difficult to enter the workforce later on.”

Investment risks. Baby boomers are getting a taste of what their Depression-era parents experienced: the devastating downside of the stock market. “Americans are starting to realize some of the realities of risk that they perhaps should have thought about a long time ago,” says Mitchell. “We have gotten lulled into a sense of security. The financial crisis should force us to pay much more attention to how much we can lose.”

After stuffing their retirement accounts with stocks for more than a decade, workers, on average, held less than half of their 401(k) money in stocks in early 2009, according to the human resources consulting firm Hewitt Associates. That’s mostly on account of market declines, but it also represents a shift to more conservative investments. Instead of chasing the highest possible return in a retirement account, retirees may want to consider significantly dialing down their risk. “Retirees need to create a decent floor to their living standard by using inflation-indexed bonds and investing in the safest way possible, which is paying off your mortgage,” says Laurence Kotlikoff, a professor of economics at Boston University and coauthor of Spend ‘Til the End: The Revolutionary Guide to Raising Your Living Standard, Today and When You Retire . If investors still want exposure to stocks, Kotlikoff recommends buying low-cost index funds.

Paying for dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>healthcare. Even though Medicare kicks in at age 65, it may not be enough to meet retirees’ dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>healthcare needs. A 65-year-old couple retiring in 2009 with Medicare insurance coverage will need approximately $240,000 to cover medical expenses throughout their retirement, up 6.7 percent from 2008, according to a Fidelity Investments estimate that includes deductibles, coinsurance costs, likely out-of-pocket expenses, and some services excluded by Medicare. The figure does not include over-the-counter medications, most dental services, and long-term care expenses–which could easily cause the costs to rise further.

Violet Lewis, 66, of San Marcos, Texas, has had Medicare insurance since she was laid off from her job in a call center in November 2008. Her medications for diabetes cost about $340 a month out of pocket. “I’m really good at calling the doctor and saying, ‘Hey, I need some samples.’ You can save a month or two of having to buy some prescriptions that way,” she says. Lewis also bought some medications in bulk to take advantage of discounts, and she tries to space out her doctor’s visits to avoid too many copays in the same month. She’s frugal in other ways, too. She uses Freecycle, a website where people exchange unneeded goods free of charge, and she started a patio garden where she grows her own vegetables. “You can grow so much in 4 square feet, and you get a pretty good meal for your effort,” Lewis says. “I bought a little freezer so I could take advantage of the sales and cook and freeze and put away.”

Unplanned retirement. Although he wasn’t planning to retire for seven more years, Milton Beach, 55, a former public affairs manager for Delphi in Kokomo, Ind., was forced into retirement in March. “It wasn’t my choice to retire,” he says. “I would have worked until I was 62.” The next month, Delphi eliminated his retiree dentalplanscoupon.com/medical-plans/integrating-leadership-development-and-continuous-improvement-practices-in-healthcare-organizations.html” title=”health”>health and life insurance coverage. Now, Beach pays about $720 per month for medical, vision, life, and dental insurance–and he’s still 10 years away from qualifying for Medicare. Beach says he’s now “recalibrating” his retirement while looking for work. To cut costs, he’s switched from name-brand products to generics, and he’s given up vacations. “There is no such thing as the golden years where you kick back and relax,” Beach says. “If you want to retire, you have to be very conservative and very judicious in terms of paying off bills.”

Jeanne Huff, 66, a retired registered nurse, and her husband, Marlin, a retired electronic technician, have been living below their means throughout their lives. The couple own their West Point, Utah, home, which Marlin insulated to save on heating and cooling costs, and they wear sweaters so they can keep the thermostat low. The Huffs drive an economical and reliable car (a Toyota Corolla), which they paid for in cash, and Marlin changes the oil and performs general maintenance himself. Jeanne grows vegetables in her garden and trades with family and friends. “We just don’t choose to do a lot of expensive things,” she says. “I think everyone will have to tighten up so people can have a good standard of living in retirement.” This probably doesn’t resemble the high life many Americans imagined they’d have in retirement, but such frugality may be what it takes to get cash-strapped baby boomers back on track.

A DODGY accent and startling false teeth were all that was needed to turn Canadian actor Mike Myers into the British super-spy Austin Powers. In “The Simpsons”, a television show, Ralph Wiggum’s dentist scares him into brushing with the decaying snaggle-teeth of the (fictional) “Big Book of British Smiles”. And there is some truth behind the awful stereotype: the factory workers of Britain’s Industrial Revolution were fed on sugar from the colonies, and led the known world in dental caries. Early in the 20th century Americans were brushing and flossing while some British dentists still believed that chomping on hard foods kept teeth strong. As recently as 1968, well over a third of British adults had not a single natural tooth in their heads.

So it is hardly surprising that, since its founding in 1948, the National Health Service has struggled to cope with the dentalplans coupon needs of the population. During its first two years it supplied 100m false teeth, and the first patient charges it introduced, in 1951, were for dentures. The legacy of bad teeth is still putting NHS budgets under strain. In recent years many dentists have turned to private practice as fees for doing NHS work have been squeezed.

On June 22nd came the latest attempt to fix NHS dentistry: an independent government-commissioned review, the third on the subject in 18 years. Changes in 2006 had been intended to simplify payments for NHS work, and to encourage dentists to concentrate less on drilling and filling and more on prevention. Instead they had unintentionally rewarded dentists for over-treating fewer patients, and forced more than ever to suffer or go private. This week’s review recommends re-complicating rates a bit, and once again paying dentists partly according to the number of NHS patients on their books. It is quite a U-turn.

How could the 2006 reforms have missed the mark so widely? By not being piloted, for one thing: the review team wants its prescriptions tested in a few areas before they are applied nationwide. A less tractable problem is that the evidence about what works is weak. Crowns and fillings are a success only if they last; trials must run for many years, by which time new materials and methods are in use.

“That means wide variations in practice, and lots of wiggle-room for dentists to respond to financial incentives,” says the review’s lead author, Jimmy Steele, a professor of dentistry at Newcastle University. And respond to the 2006 changes dentists did, doing fewer tricky root canals and more extractions, referring more acute cases to dental hospitals and halving the treatments involving laboratory work.

More generally, the gap between the necessary and the cosmetic is wider in dentistry than other areas of medicine, making it hard to agree on what the state should subsidise. Bridges or implants? How crooked is too crooked? How stained is too stained? The value placed on saving a tooth varies wildly from person to person, the review team found, from nothing at all to as much as Pounds 10,000 ($16,500) for a molar. Generations differ, too. Few of Britain’s “heavy metal generation”–the 45-75-year-olds with mouths full of amalgam–aspire to Hollywood-style teeth, because they look far too similar to their parents’ and grandparents’ dentures. Should their taxes go towards capping and bleaching the teeth of youngsters who rather fancy the perfectly even, blue-white look?

As for advising on prevention, which is probably the most important part of modern dentistry, there is a problem. Britons who visit the dentist feel cheated if all they get is a quick peer and a reminder to floss. But that may change, and surprisingly quickly. Probably because treatment is easily available to children on the NHS, Britain is one of a handful of OECD countries where 12-year-olds have fewer than one decayed, filled or missing tooth per head. (In Europe, only Danish and German children do as well.) British teeth could soon be dazzling the world.

So it is hardly surprising that, since its founding in 1948, the National Health Service has struggled to cope with the dentalplans coupon needs of the population. During its first two years it supplied 100m false teeth, and the first patient charges it introduced, in 1951, were for dentures. The legacy of bad teeth is still putting NHS budgets under strain. In recent years many dentists have turned to private practice as fees for doing NHS work have been squeezed.

On June 22nd came the latest attempt to fix NHS dentistry: an independent government-commissioned review, the third on the subject in 18 years. Changes in 2006 had been intended to simplify payments for NHS work, and to encourage dentists to concentrate less on drilling and filling and more on prevention. Instead they had unintentionally rewarded dentists for over-treating fewer patients, and forced more than ever to suffer or go private. This week’s review recommends re-complicating rates a bit, and once again paying dentists partly according to the number of NHS patients on their books. It is quite a U-turn.

How could the 2006 reforms have missed the mark so widely? By not being piloted, for one thing: the review team wants its prescriptions tested in a few areas before they are applied nationwide. A less tractable problem is that the evidence about what works is weak. Crowns and fillings are a success only if they last; trials must run for many years, by which time new materials and methods are in use.

“That means wide variations in practice, and lots of wiggle-room for dentists to respond to financial incentives,” says the review’s lead author, Jimmy Steele, a professor of dentistry at Newcastle University. And respond to the 2006 changes dentists did, doing fewer tricky root canals and more extractions, referring more acute cases to dental hospitals and halving the treatments involving laboratory work.

More generally, the gap between the necessary and the cosmetic is wider in dentistry than other areas of medicine, making it hard to agree on what the state should subsidise. Bridges or implants? How crooked is too crooked? How stained is too stained? The value placed on saving a tooth varies wildly from person to person, the review team found, from nothing at all to as much as Pounds 10,000 ($16,500) for a molar. Generations differ, too. Few of Britain’s “heavy metal generation”–the 45-75-year-olds with mouths full of amalgam–aspire to Hollywood-style teeth, because they look far too similar to their parents’ and grandparents’ dentures. Should their taxes go towards capping and bleaching the teeth of youngsters who rather fancy the perfectly even, blue-white look?

As for advising on prevention, which is probably the most important part of modern dentistry, there is a problem. Britons who visit the dentist feel cheated if all they get is a quick peer and a reminder to floss. But that may change, and surprisingly quickly. Probably because treatment is easily available to children on the NHS, Britain is one of a handful of OECD countries where 12-year-olds have fewer than one decayed, filled or missing tooth per head. (In Europe, only Danish and German children do as well.) British teeth could soon be dazzling the world.

A little toothache can pretty quickly turn into a big headache -not just for your mouth but for your wallet too. That’s why CIGNA‘s new series of dental HMO plans places an even greater emphasis on affordability and promoting wellness by covering more preventive dental care services.

For example, under the new plans, up to four routine cleanings a year – two at no cost and two for a minimal copay — are covered when recommended by the dentist. Children are covered for two fluoride treatments a year to help prevent tooth decay, one of the most common chronic infectious diseases among U.S. children1.

“If you have dental insurance, you might pay nothing or very little out of your pocket for a routine dental visit (cleaning, x-rays and exam), compared with an average of $150 or more if you don’t have coverage,” said Dr. Miles Hall, chief dental clinical director for CIGNA*. “If you need to have a cavity filled, on average the cost would be $115 or more without insurance compared to low or no cost with our dental HMO plan. Waiting too long to treat a small cavity could mean you’d pay many times more for more costly dental procedures, such as a root canal, and spend more time away from work and personal life to recover. The key message we’re sending with the new plan designs is ‘prevention matters, so don’t wait.’”

Hall said CIGNA is also changing some aspects of plan rules to make it easier for people to schedule their preventive dental care. Under the new plans, which are available now, the company is doing away with the requirement that cleanings be done at least six months apart.

In addition, the new plans cover teeth whitening – the kind of gel bleaching with take-home trays that many dentists offer. The plans continue to include important preventive features such as no age limitation on sealants, no referrals needed for orthodontic care, no referrals needed for care by a network pediatric dentist for children under 7, and coverage for procedures to help detect oral cancer early.

According to Bebe Shuler-Mure, assistant vice president of product for CIGNA’s dental products, CIGNA has been working to broaden the network of dentists who participate in the dental HMO plan and now has over 13,600 unique dentists who practice among over 43,500 office locations in the network, one of the largest dental HMO networks in the country. Individuals can locate an in-network dentist using the dental directory on www.cigna.com.

At a time when the affordability of coverage is a concern for both employees and employers, the new plans are offered with a range of benefit and copay options.

“CIGNA’s new dental HMO plans have more options available than many other carriers, including standard plans, plans with and without orthodontia coverage, specialty dental care discount, and split copay plans where copays are lower for using a general dentist and higher for dental specialty care,” said Shuler-Mure. “This array of options gives employers flexibility to continue to provide a dental plan, even if their benefits budgets are under strain due to the economic downturn. The plans are also available on what is known as a voluntary (employee-paid) basis, where employees can get the advantage of obtaining insurance at lower, group rates.”

CIGNA is also using its diverse product capabilities to provide value-added services for people in its dental plans. CIGNA will offer identity theft resolution services free of charge for individuals covered under the new series of dental HMO plans. Someone who falls victim to identify theft can be guided through the steps to recovery by an identify theft expert, 24 hours a day, 7 days a week, at no charge.

In addition, through the CIGNA Healthy Rewards(R) Program, individuals can get discounts on gym memberships, weight management programs such as WeightWatchers(R) and NutriSystem(R), retail coupons through Linkwell, massage therapy, laser vision correction, tobacco cessation and more.

*Estimated costs without dental coverage may vary based on location and dentists’ actual charges. These estimated costs are based on charges submitted to CIGNA as of February, 2009.

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Thorstensson H, Johansson B. Does oral health say anything about survival in later life? Findings in a Swedish cohort of 80+ years at baseline. Community Dent Oral Epidemiol 2009; 37: 325-332. © 2009 John Wiley & Sons A/S

Oral health is an integral part of general health; oral health contributes to and is influenced by a nexus of inputs from biological, psychological, and social functioning. Little is known about the relationship between markers of oral health and subsequent survival in late life.

The aim of this study was to examine the relative importance of oral health indicators in the context of demographic and psychosocial variables on subsequent survival during an 8-year period in a population-based sample of the oldest-old.

The study sample comprised 357 individuals with a median age of 86 years who were selected from participants in the comprehensive longitudinal Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) study, which examined monozygotic and dizygotic twins aged 80 years and older on five occasions at 2-year intervals. The OCTO-Twin study includes a broad spectrum of biobehavioural measures of health and functional capacity, personality, well-being, and interpersonal functioning. Oral health variables were number of teeth, per cent decayed and filled surfaces (DFS%), and periodontal disease experience. A longevity quotient (LQ), the ratio between years actually lived and those statistically expected, was determined. The survival categories were shorter than expected, as expected, or longer-than-expected. Multivariate analyses and the Kaplan-Meier method were used in the survival analyses.

No associations between LQ and number of teeth, edentulousness, and periodontal disease experience were found. But survival of men with severe periodontal disease experience was shorter than expected. DFS% was significantly associated with survival. Individuals with a low number of decayed and filled surfaces (DFS) had a shorter-than-expected survival time compared with those with high DFS scores. The overall predictor of survival was cognitive status, independent of age and gender when dental variables were analysed in the context of psychosocial factors. In addition, number of teeth, smoking, and better financial status in childhood and during working life were also significant predictors.

Oral health was significantly associated with subsequent survival in a sample of oldest-old individuals, although psychosocial factors were stronger predictors.

Watson JM, Logan HL, Tomar SL, Sandow P. Factors associated with early-stage diagnosis of oral and pharyngeal cancer. Community Dent Oral Epidemiol 2009; 37: 333-341. © 2009 John Wiley & Sons A/S

The objective of this study was to examine the characteristics and treatment-seeking behaviors of patients diagnosed with oral and pharyngeal cancer (OPC) and to determine whether seeing an oral healthcare provider in the preceding year was associated with an earlier stage of diagnosis.

Trained interviewers administered a pretested survey instrument to a sample of 131 patients newly diagnosed with OPC at two cancer centers in Florida. Analyses were conducted to compare characteristics of patients by cancer summary stage (early or advanced) on receipt of OPC examination, patterns of dental care, and number of initial signs and symptoms. In addition, analyses were also conducted for characteristics of patients’ dental care utilization (regular primary care dentist, time of most recent dental visit, and regular dental care) by receipt of OPC examination.

Overall, 25.3% of participants reported receiving an OPC examination at their last dental visit and participants who received an OPC examination were significantly more likely (79%) to be diagnosed at early stages than those who did not receive an oral cancer examination (48%). Patients with a regular primary care dentist were more likely to be diagnosed at early stages (65%) than those without a regular primary care dentist (41%). Factors significantly associated with receiving an OPC examination included having a regular primary care dentist ( P < 0.001), having a dental visit in the preceding 12 months ( P < 0.001), and receiving regular care ( P < 0.001). The number of signs or symptoms reported by the patient was significantly associated with the stage at diagnosis ( P = 0.002) and the most common initial symptom reported by patients was soreness in the mouth.

Thorstensson H, Johansson B. Does oral health say anything about survival in later life? Findings in a Swedish cohort of 80+ years at baseline. Community Dent Oral Epidemiol 2009; 37: 325-332. © 2009 John Wiley & Sons A/S

Oral health is an integral part of general health; oral health contributes to and is influenced by a nexus of inputs from biological, psychological, and social functioning. Little is known about the relationship between markers of oral health and subsequent survival in late life.

The aim of this study was to examine the relative importance of oral health indicators in the context of demographic and psychosocial variables on subsequent survival during an 8-year period in a population-based sample of the oldest-old.

The study sample comprised 357 individuals with a median age of 86 years who were selected from participants in the comprehensive longitudinal Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) study, which examined monozygotic and dizygotic twins aged 80 years and older on five occasions at 2-year intervals. The OCTO-Twin study includes a broad spectrum of biobehavioural measures of health and functional capacity, personality, well-being, and interpersonal functioning. Oral health variables were number of teeth, per cent decayed and filled surfaces (DFS%), and periodontal disease experience. A longevity quotient (LQ), the ratio between years actually lived and those statistically expected, was determined. The survival categories were shorter than expected, as expected, or longer-than-expected. Multivariate analyses and the Kaplan-Meier method were used in the survival analyses.

No associations between LQ and number of teeth, edentulousness, and periodontal disease experience were found. But survival of men with severe periodontal disease experience was shorter than expected. DFS% was significantly associated with survival. Individuals with a low number of decayed and filled surfaces (DFS) had a shorter-than-expected survival time compared with those with high DFS scores. The overall predictor of survival was cognitive status, independent of age and gender when dental variables were analysed in the context of psychosocial factors. In addition, number of teeth, smoking, and better financial status in childhood and during working life were also significant predictors.

Oral health was significantly associated with subsequent survival in a sample of oldest-old individuals, although psychosocial factors were stronger predictors.

Mutations in the NHS (Nance-Horan Syndrome) gene lead to severe congenital cataracts, dental defects and sometimes mental retardation. NHS encodes two protein isoforms, NHS-A and -1A that display cell-type dependent differential expression and localization. Here we demonstrate that of these two isoforms, the NHS-A isoform associates with the cell membrane in the presence of intercellular contacts and it immunoprecipitates with the tight junction protein ZO-1 in MDCK (Madin Darby Canine Kidney) epithelial cells and in neonatal rat lens. The NHS-1A isoform however is a cytoplasmic protein. Both Nhs isoforms are expressed during mouse development. Immunolabelling of developing mouse with the anti-NHS antibody that detects both isoforms revealed the protein in the developing head including the eye and brain. It was primarily expressed in epithelium including neural epithelium and certain vascular endothelium but only weakly expressed in mesenchymal cells. In the epithelium and vascular endothelium the protein associated with the cell membrane and co-localized with ZO-1, which indirectly indicates expression of the Nhs-A isoform in these structures. Membrane localization of the protein in the lens vesicle similarly supports Nhs-A expression. In conclusion, the NHS-A isoform of NHS is a novel interactor of ZO-1 and may have a role at tight junctions. This isoform is important in mammalian development especially of the organs in the head.

Most brand extension studies follow the assumption that brand extensions use the full original parent brand name (e.g., Oral-B tooth brush may extend to Oral-B dental floss). However, some companies use derived brand names in their brand extension strategies (e.g. Nestea Iced Tea). This study explores the advantages and disadvantages of derived brand extensions compared to full name extensions. The study examines the importance of target market effects on the evaluation of both brand extension strategies. Findings support the idea that derived brand names leverage parent brand evaluations and protect parent brand from extension failures.