Ongoing reforms of the dental industry are likely to have an effect on the benefits market, but employers are still keen to offer dental plans to their workforces, says Tynan Barton

A few years ago tabloids raged about long queues to obtain a place with an National Health Service (NHS) dentist and ran scare stories on the DIY treatment people were inflicting on themselves. However, figures released in March from The Health and Social care Information Centre show a minor improvement to the number of patients now seen by NHS dentists – up 0.7% over the previous 24 months; now at 55.1% of the population.

This can be attributed to changes introduced by the last government, which included the 2006 reforms aimed at improving patient access to NHS dentistry services and simplifying payment for dental treatment. Primary care trusts (PCTs) were also put in charge of commissioning local dental services and deciding where to locate new services. The independent Steele review, published in June 2009, then sought to ensure widespread changes were made to NHS dental contracts in order to increase access to dental services and improve service quality.

However, this year’s change of government and the announcement of budget cuts have raised doubts over the direction of dental policy. A key concern for the industry is that PCTs will be free to allocate funds anywhere they like.

Morag Peterson, product manager at Cigna Healthcare, says: “It is possible dentistry will take a lower priority when it comes to how they allocate that money. The new government is going to take little control and it is going to be up to the PCTs, so it is going to vary by postcodes as to how that money is spent.”

Product design

All these changes could impact on the dental benefits market, particularly in terms of product design. James Glover, corporate sales and marketing director at Simplyhealth, says: “There is a state of anticipation, of waiting to find out what exactly the changes are going to be, if any, how the market should respond to that, and how, as a consequence, employee benefits geared towards accessing dental treatment should be designed.”

The changes may result in more dentists choosing to go private, further limiting access to NHS dental services. This could lead to an increase in the number of employers offering dental benefits to staff. Chuck Misasi, senior vice president at dental network provider Munroe Sutton, says: “The trend is going to be that employers will continue to seek out dental benefits – cash plans and insurances – because more and more people are having trouble finding an NHS dentist.”

There are two main types of dental benefit that employers can offer their staff: dental cover within a health cash plan and dental insurance. The former provides money back on everyday dental bills up to an annual limit, while dental insurance offers more comprehensive cover.

At their most basic level, all dental benefits include routine check-ups and treatment, accident and injury cover, and cover accessing NHS and private treatment. These basics are typically subject to a fixed annual monetary limit, which will vary depending on the type of plan offered.

Over the past few years, the dental benefits market has been relatively flat. Pam Whelan, corporate sales manager at Denplan, says: “The awareness and appreciation of what a dental plan brings to a benefits package has not diminished. Employers that were looking to implement a scheme may have pushed it back, but nobody has been turned off from moving forward with plans that had already been made. It is not recession-proof but, equally, we have not seen as big an impact on the business as previously anticipated.”

Lara Rendell, marketing manager at Health Shield, agrees that dental plans are still popular. “There has been an increase in the call to employers to look after staff and their health and wellbeing,” she says. “They have always been keen to provide dental as a benefit, but, if anything, I think there has been an increase in them wanting to help employees through these difficult times.”

Improved morale

In Simplyhealth’s Annual dental research, published in March 2010, 67% of respondents said dental benefits improved staff morale and 66% said they reduced sickness absence. A further 74% said it was the responsibility of the organisation to look after its workforce’s oral health.

Being seen to care about employees’ wellbeing by offering dental perks can also help an employer become an employer of choice. Cigna’s Peterson says: “Employees’ needs are going to increase, so it is going to be seen as more of a recruitment and retention benefit. People are going to be struggling to get the dental care they need, and there is an opportunity here for the employer to meet that need.”

To help meet this demand, providers have continued to bring new products to market. For example, in April, Bupa launched a new flexible dental plan offering five benefit levels. Premiums start at pound 3.51 a month.

Cost remains an issue for many employers in the current economic climate. Offering dental benefits through health cash plans is a popular choice because of the ease of implementation and the low cost.

Dental cover can also be included in private medical insurance (PMI) schemes, although this can be more expensive. Denplan’s Whelan says: “Employers recognise that dental is an integral part of employee wellbeing and complements the existing PMI offering. Typically, an organisation that is committed to improving employee wellbeing will look at providing dental benefits in addition to PMI.”

The trend of offering dental through flexible benefits is still gaining popularity among employers as they recognise it as a way to offer dental benefits in a difficult economic climate while controlling the cost to the organisation.

According to Michelle Bishop, business development manager at National Dental Plan, employers that are planning to roll out such schemes typically have a long-term focus. “In some cases, you will have people opt for voluntary arrangements in the first place, in order to prepare to go into a flexible benefits arrangement, so they can provide the benefit as soon as possible,” she says.

Focus on facts

What are dental benefits?

Dental benefits allow employees to claim back part, or all, of the cost of dental treatment. They can be provided through a health cash plan or as an insurance product. The level of cover can vary, ranging from accident and emergency treatment to treatment for cancer.

What are the origins?

Dental insurance products first appeared in the UK during the 1980s. However, these were preceded by dental cover made available though a health cash plan.

Where can employers get more information and advice?

View articles on health benefits: employeebenefits.co.uk/benefits/healthcare-wellbeing.html

Nuts and bolts

What are the costs involved?

Costs vary depending on the level of cover required, the way a scheme is funded and the number of employees covered. Accident and emergency dental cover can cost from pound 3 a month per employee. The average cost of dental insurance is approximately pound 10 to pound 15 a month per employee.

What are the legal implications?

There are no legal implications in offering staff dental perks.

What are the tax implications?

Dental perks are classed as a benefit in kind, so staff are liable for tax and national insurance.

In practice

What is the annual spend?

According to Laing and Buisson, the spend on employer-paid dental insurance in 2009 was pound 42.3m. The total dental insurance market is worth pound 75.9m.

Which providers have the biggest market share?

Market commentators say Denplan and Cigna Healthcare are dominant players. Other providers include: Aviva, Axa PPP Healthcare, BHSF, Bupa, Cigna Healthcare, Dencover, Denplan, Health Shield, HSF, Medicash, Munroe Sutton, National Dental Plan, National Friendly, Simplyhealth, Standard Life, Westfield Health and WPA.

Which have increased their share?

There are no figures available, but Simplyhealth continues to increase its presence in the market.

July 26–It began with a toothache. Tori Pence, 23, could feel the hole that had suddenly developed on her tooth, and she couldn’t stand either hot or cold food. The bespectacled girl with electric-blue hair had worked a string of odd jobs and hadn’t seen a dentist for at least five years.

When she finally got in to see one, she needed a root canal. And fillings for 15 cavities.

“Dentally speaking, I am healthy now,” says Pence, who lives in Lansdowne and has been making monthly visits to the University of Pennsylvania’s dental clinic for almost a year. “But I still have seven more [cavities] to go.”

Pence is one of the estimated 132 million people in the United States without any sort of dental insurance. It’s an endemic problem among the unemployed, the poorly paid, and those without medical insurance.

While the national health-care act passed in spring will increase the number of people eligible for medical insurance, its effects on dental will be mixed.

The law increases coverage for children, and will eventually cover more adults under Medicaid, the joint state-federal health plan for the poor. But adult dental services are often hard to find: Less than one-third of dentists in Pennsylvania and New Jersey participate in Medicaid.

Many people don’t see the value in preventive dental care — or they dread it — and postpone routine checkups. That is, until it becomes too painful to chew or a front tooth is chipped.

In Philadelphia, geriatric dentist Ann Slaughter says many elderly patients she has examined at inner-city senior centers haven’t seen a dentist for up to 15 years.

But “oral health is intimately connected to overall health,” she says.

Periodontal disease can cause or worsen heart conditions, strokes, and respiratory illness.

It can be perilous for diabetics. Germs from gum disease can make them more prone to complications, says Slaughter, an assistant professor at the University of Pennsylvania School of Dental Medicine and a member of the city Board of Health.

More than 200 diseases of the mouth can also cause problems elsewhere in the body. The plaque on teeth can travel into the blood and contribute to hardened arteries, a risk for heart attack.

In 2000, Surgeon General David Satcher called dental and oral diseases a “silent epidemic” facing the nation.

“We’re in 2010, and we haven’t made many advances,” Slaughter notes. “That’s the sad part.”

One problem is the many gaps in dental insurance, which unlike medical insurance, was never intended to completely cover anything.

For those without insurance, the median price for a root canal in Philadelphia is $862, according to a survey that dentists use to price procedures. A crown can cost as much as $1,200.

And while 172 million Americans under 65 have private health insurance, just 45 million of them have any sort of dental plan, according to the National Center for Health Statistics.

In Pennsylvania, 40 percent of the entire population of adults and children lacks dental insurance, according to the Pennsylvania Dental Association.

Medicare has substantial holes as well. It covers health care for virtually all seniors and some younger people with permanent disabilities. But it doesn’t pay for routine dental care.

When people turn 65, says Slaughter, “those with disposable incomes pay out of pocket or they keep their dental insurance.”

Medicare does cover dental procedures that are connected to a larger medical issue. A surgeon won’t perform an open-heart operation on a patient who has a mouth abscess, for example, until a dentist has treated the problem.

Medicaid poses its own challenges. There are 508,000 recipients in Philadelphia, but many of the adults aren’t eligible for dental because they aren’t permanently disabled or fail to meet other criteria.

Those who are eligible can have a hard time finding a dentist.

“Just because you have insurance doesn’t mean you have access,” says Laval Miller-Wilson, the executive director of the Pennsylvania Health Law Project.

Pennsylvania has some of the lowest reimbursement rates in the country, according to a recent report by the Pew Center on the States. Pennsylvania’s Medicaid program reimbursed dentists 53 percent of what they customarily charge. The national average for Medicaid is 60.5 percent.

New Jersey had among the nation’s lowest reimbursement rates until recently, but now pays 103 percent of the customary fee, according to the Pew Center, which nevertheless gave the state an F on its dental report card due to other limitations of coverage for the poor. (Pennsylvania also got an F.)

Miller-Wilson says some dentists’ aversion to Medicaid is about more than money. The paperwork is cumbersome. And broken and late appointments are common among the poor.

Instead of accepting Medicaid, “many dentists say they would rather treat patients during free clinics or pro bono,” says Rob Pugliese, spokesman for the Pennsylvania Dental Association.

Lack of increased funding for Medicaid dental services is a major reason the American Dental Association opposed the health-care bill.

In 2014, when the new law enables millions more Americans to join Medicaid, many advocates wonder if there will be longer lines to see dentists as well as doctors.

“The health-coverage bill is going to exacerbate the current supply problem,” says Miller-Wilson, adding that the state of dental care now may foreshadow what is to come.

Many advocates point to the 2007 death of 12-year-old Deamonte Driver in Prince George’s County, Md., as the impetus for Congress to make sure that dental was included in the basic benefits package for children on Medicaid.

Driver died from a bacterial infection caused by an abscess in his mouth. His mother had been unable to find a dentist who would accept his Medicaid.

Philadelphia’s Slaughter wonders whether “it will take another catastrophe like Driver’s to get policy makers’ attention.”

Even if coverage is broadened, other issues remain.

Pence, the woman with 15 cavities, is in many ways typical of her generation. She was cut off from her father’s health and dental insurance when she turned 18. She ignored her teeth for several years as she worked part time.

Last September, the pain became overwhelming. Following her aunt’s advice, she went to Penn’s dental clinic to get treated at a reduced rate.

In March, she started working a full-time job with benefits. She can now afford yet another fix: the skin graft she needs at the base of her bottom front teeth. Her tongue piercing had worn down the gums so much that “you can see the roots of my teeth,” Pence says.

She has since removed the piercing. She promises to see her dentist regularly in the future.

Reduced-Fee Dental Clinics in Region

Donated Dental Services

717-238-8721

www.nfdh.org (Locations throughout Southeastern Pennsylvania)

Philadelphia

City health centers

Seven of the clinics offer dental services. Call 215-686-1776 for locations, or go to www.phila.gov/health/Services/Serv_DentalCare.html

(Medicaid accepted)

Afton Family Dental PC

215-462-6229

Fairmount Primary Care

Center

215-684-5349

www.dvch.org

Maria de los Santos Health Center

215-291-2509

www.dvch.org

(Medicaid accepted)

Frankford Avenue/Hunting Park/Snyder Dental/Wilson Park Medical Centers

215-229-1390

www.gphainc.org

(Medicaid accepted)

Vaux Family Health Center

215-236-8289

www.qchc.org

(Medicaid accepted)

QCHC Family Health Center

215-227-0300

www.qchc.org

(Medicaid accepted)

University of Pennsylvania School of Dental Medicine Dental Clinic

215-898-8965

www.dental.upenn.edu

(Medicaid accepted)

Ronald McDonald Care Mobile

215-427-8877

(Free for qualified children; Medicaid accepted)

Clinic of Temple University Kornberg School of Dentistry

215-707-2900

www.temple.edu/dentistry

(Senior citizen discount; Medicaid accepted)

Bucks County

Bucks County Health Improvement Project

1-800-347-6803 (Free for qualified children)

Ann Silverman Community Health Clinic

215-345-2410

HealthLink Medical Center

215-364-4247

www.healthlinkmedical.org

Chester County

Community Volunteers in Medicine

610-836-5990

www.cvim.org

(Free)

The Children’s Dental Clinic

610-240-1213

Delaware County

ChesPenn Health Services

610-874-6231; 610-497-2900

Montgomery County

Manor Dental Health Center

215-887-7617

www.manor.edu

Greater North Penn Dental Initiative

1-877-466-7764

(Medicaid accepted)

Norristown Regional Health

Center

610-278-7787

www.dvch.org

(Medicaid accepted)

The Abram and Goldie Cohen Dental Programs Center

610-526-6015

www.harcum.edu

(Medicaid accepted)

Camden County

Camden County College, Dental Hygiene Clinic

856-374-4930

CamCare Health Corporation — East

856-635-0307

(Medicaid accepted)

CamCare Health Corporation — Gateway Center

856-963-8768

(Medicaid accepted)

CamCare Health Corporation — Clementon

856-627-7701

(Medicaid accepted)

UMDNJ — Somerdale

856-566-6969

(Medicaid accepted)

Virtua Dental Health Center

856-246-3545

(Medicaid accepted)

SOURCES: Pennsylvania and New Jersey dental associations

Contact staff writer Brooke Minters at 215-854-2244 or bminters@phillynews.com.

Credit: The Philadelphia Inquirer

As much as we might hope to buy coverage in a pinch, insurance companies are smarter than that. They might cover exams and X-rays immediately, but fillings and oral surgery usually require a one- to two-year wait.

Instead, the reader bought into a discount network and saved about $800 after purchasing an individual membership for $100 a year. The waiting period before her benefits kicked in? Three days.

It’s called a discount dental plan and it’s similar to buying a membership at Costco or Sam’s Club. For the price of your annual membership, you get the benefit of paying lower prices on the products or services offered.

The dentists who participate in the program agree to accept a discounted fee from the plan as payment in full for their services. For example, a white filling is typically $173, but discount plan members pay $51 to $116, depending on the plan. A crown is typically $1,200, but members pay $473 to $1,000.

Annual membership fees range from $80 to $160 for an individual and $130 to $200 for a family.

One of the best ways to shop for a plan is at www.dentalplans.com. It has aggregated plans from more than 30 companies, including Aetna and Cigna. After putting in a ZIP code, you can find dentists in your area who accept the plans and what the discounted rates are for fillings, crowns, root canals and dentures.

Most people have never heard of the discount plans, probably because nearly 70 percent of Minnesotans have dental insurance, said Loren Hanson, director of marketplace activities at the Minnesota Dental Association in Minneapolis.

But even those with insurance might want to consider a dental plan if they have some unexpected big bills. Dental insurance typically has a maximum benefit per year of $1,000 to $1,200. Anyone who has already met the annual maximum and develops a new toothache is unlikely to wait until January to get it fixed.

Hanson said the MDA has had few complaints about the discount dental plans but says many patients will find that their dentist doesn’t offer the discounts. About 10 percent of dentists in the Twin Cities offer them, he said.

Dental plans have a 30-day cancellation policy and no waiting periods, deductibles or maximums. Orthodontia and cosmetic procedures are included in some plans. DentalPlans.com is offering a 10 percent discount with the code “July10,” but when I called several months ago I was offered a 20 percent discount after I balked about joining. Call 1-888-632-5353 or visit the website.

Cosmetic dentistry has been a staple of dental practices since the ’90s, when the widespread availability of teeth whitening products revolutionized the market.

Even the recession couldn’t vanquish vanity; steady consumer demand for teeth bleaching, tooth-colored fillings, implants and other cosmetic procedures has kept dentists smiling through today’s tough economic times. It’s also helped keep dental benefits popular and prompted some leading dental insurers to broaden plan coverage to include cosmetic services.

“More and more dentists see cosmetic procedures as a way to increase their revenue,” says Dr. Roma Virani, second vice president, Dental Cost & Utilization at Assurant Employee Benefits. For example, “most practices are doing tooth-colored fillings. It used to be that only a third of the fillings on back teeth were composites. Now that is reversed.

“While some people are concerned about the safety of amalgams,” she continues, “the switch is primarily driven by aesthetics. You get equally good results, so one type is not better than the other. However, people want their fillings to be tooth-colored so they are not as visible.”

Whitening leads the way

By far the most popular cosmetic procedure is teeth whitening. Dental magazines report that the most common conversation dentists have with their patients is about bleaching. Bradley Dykstra, DDS, wrote about the trend in Dental Economics magazine in April.

“The quest of baby boomers to stay forever young and society’s expectations to look our best drives this demand,” he says. “It is important to understand that patients, both male and female, want whiter teeth – period.”

Until a few years ago, bleaching was not covered by dental benefit plans. This changed when a handful of dental plan providers heeded requests from brokers and employers for voluntary insurance products that would offset the cost of cosmetic dental procedures for employees.

“All insurers in this industry are always looking for something new and different for brokers to sell,” says Kevin Martin, dental product development leader at Sun Life Financial. “Cosmetic was something the industry shied away from because it was not necessary care. Sun Life came up with the thought that since people want nice, shiny teeth, wouldn’t it be nice to offer a benefit that covers some, but not all, of the cost. I guess covering cosmetic was our iPod.”

Sun Life offers two cosmetic dental riders to its insurance plan. One covers teeth whitening done in the dental office or at home with products provided by the dentist. The other includes veneers as well as whitening.

The cost of the riders is based on the annual maximum selected and adds 3% to 6% to the standard dental insurance premium.

“It’s all about the smile,” maintains Paul Sherman, vice president and national sales director for American General Benefits Solutions, which began covering cosmetic procedures under its voluntary “Smile Maker” benefit plan two years ago.

Smile Maker currently covers teeth whitening and implants and will soon be expanded to include implants and composite fillings, according to dental product manager Sadia Zoppi. “It works like a lifetime orthodontia benefit for each family member,” she says. “About 2% of our business has this feature, but we anticipate that it will increase as more plan sponsors ask employees to contribute to the cost of their dental plan.”

The Smile Maker add-on is $8 per month for an individual and $32 per month for a family. “That can be a substantial increase in cost on a lower-priced dental plan that’s, say, $50,” notes Zoppi.

These products are expensive in nature, says so you’d expect this, says Zoppi. “But they are still very attractive, and they are meeting a need. There is a growing demand for these services.”

According to AACD, the mean amount spent by the average patient in 2006, the last year for which data is available, was $5,640 and the median was $3,860. At the high end, 3% of practices indicated an average amount spent per patient of $20,000 or more.

At the other extreme, 2% of practices reported average patient costs of less than $500. The most often indicated categories were $5,000-$9,999 (23%) and $2,500-$4,999 (22%).

Assurant Employee Benefits also was one of the first to cover teeth bleaching. Some of its plans also include posterior composites and porcelain crowns on posterior teeth, which it considers restorative rather than cosmetic.

“Going along with these trends, Assurant has come out with products that will take employees’ benefits farther,” says Virani. “We have Family Share Max and Preventive Max Waiver products that give more benefit dollars to plan members for these services. With the Preventive Max Waiver, preventive work does not count toward the annual maximum, so more dollars are available for non-preventive services.

“This supports our belief that if patients are getting preventive work done, they’ll need less restorative work in the future.”

Guardian broke new ground in 2004 when it extended coverage to implants. The company also offers coverage for whitening, posterior composites, porcelain inlays and onlays, and porcelain crowns and veneers.

“We take a lot of pride in customizing our plan designs to meet brokers’ and plan holders’ price points,” says Dr. Richard Goren, second vice president of Guardian’s group dental unit.

“There are hundreds of options. No one offers everything that we do.”

Brighter smiles, better health

Dentists view cosmetic dentistry not only as a means to increase revenue, but also as an important way to improve Americans’ oral health.

“If I want to whiten my smile, the dentist is going to talk about restorative needs before doing cosmetic work,” says Goren. “The motivation for a bright smile and white teeth is coming from the individual patients, and the drive for overall care is coming from the dentists.”

Like bleaching and tooth-colored fillings, implants improve patients’ appearance and promote self-esteem. But they also can help prevent problems down the road, Goren notes. “Bridge work involves shaving the tooth and cementing the bridge on top of it. When that happens, the tooth is never as good as when it was healthy. With an implant, no one is contributing to a tooth’s demise.”

Dermal filler next?

Dermal filler therapy may be a natural progression of where the cosmetic dental industry is heading, according to Goren. “With proper training, these procedures are easy for dentists to accomplish. Patients are motivated to accept these therapies and excited about having them done under local dental anesthesia, making dentists the health care professionals of choice to deliver these procedures.”

Whether dental plan providers will push the cosmetic coverage envelope to cover dermal filler therapy remains to be seen. Meanwhile, however, a new national movement is underway among dentists that could spark discussions about including cosmetic procedures as part of basic dental plans.

The dental industry has been lobbying across the country for states to prohibit insurers from negotiating discounts on services that are not covered.

Because there is a great deal of discounting on cosmetic procedures, this trend is significant, according to Evelyn Ireland, executive director of the National Association of Dental Plans in Dallas.

“The dentists feel that they are in an unequal, negative position,” she says. “Their position is if a carrier won’t pay toward a service, they shouldn’t be required to discount it.”

“The no-discounts on non-covered services legislation is not very consumer friendly,” says Virani. “If a service that is cosmetic in nature is not covered, the dentist will have better luck convincing the patient to have it done if it can be provided at a discount. Discounts are the cornerstone of PPO products, so this is changing things quite a bit.”

“Carriers aren’t happy [with these regulations] because employees are losing out on discounts,” agrees Martin. “It is possible that we’ll see a resurgence of requests for coverage for cosmetic services because then we could offer a discounted fee if that’s requested.”

Discounted or not, there’s no doubt that patients will continue to request cosmetic procedures and dentists will continue to expand the scope of these services.

“It’s a nice time to be a dentist when you have patients who are smiling, looking good and you know they have a healthy mouth,” says Guardian’s Goren. “It’s a stark contrast to getting feedback that it hurts and they don’t like anything you can do for them.”

By the numbers

In 2007, the American Academy of Cosmetic Dentistry put the market for cosmetic dental procedures at $2.75 billion, based on a 2006 survey of its members. Of that, $138.8 million was for bleaching and whitening, $383 million was for posterior composites, or rear fillings, and $144.3 million was for implants. The total number of patients seeking cosmetic services was estimated at 2.69 million, which represented a 12.8% increase over 2005. Furthermore, the survey respondents expected another 11% increase in patients and revenue in 2007.

Credit: By Lynn Gresham

Dental care can really take a bite out of your wallet. Even if you have insurance — and just over half of people do, says the National Association of Dental Plans — the typical co-insurance is only 50% on major procedures such as root canals, bridges, and crowns, which run $750 and up. Here’s how to manage those costs so that you don’t end up putting too much money where your mouth is: 1. Don’t rush for coverage. 2. Pay for prevention. 3. Investigate discounts. 4. Ask about stopgaps.

Baby teeth are vulnerable to tooth decay from their very first appearance, on average between the ages of six and 12 months. Pediatric dentists specialize in caring for these tiny teeth, imperative for proper speech development and nutrition. The specialized care offered by a pediatric dentist includes unique strategies for working with children that alleviate fear and anxiety through the use of positive reinforcement and behavior guidance. Pediatric dentists monitor babies’ growth and development and provide essential dentistry services including tooth cleaning, polishing and fluoride treatment.

For healthy smiles, dental care must be established in – and out – of the pediatric dentist’s chair. The AAPD recommends the following at-home methods for infant oral health care:

Clean infant mouths and gums regularly with a soft infant toothbrush or cloth and water.

Children older than six months need fluoride supplements if their drinking water does not contain enough fluoride. Fluoride supplementation in infants has been shown to reduce tooth decay by as much as 50 percent. Check with your pediatric dentist first.

Babies should be weaned from the bottle by 12-14 months of age and at will breast-feeding should be discouraged.

Baby teeth should be brushed at least twice a day with a toothbrush made for small children using a “smear” of fluoridated toothpaste.

Visit www.aapd.org for more information or to locate a pediatric dentist.

The American Academy of Pediatric Dentistry

Founded in 1947, the AAPD is a not-for-profit membership organization representing the specialty of pediatric dentistry. AAPD’s 7,600 members are predominately pediatric dentists and primary care providers who deliver comprehensive specialty treatments for infants, children, adolescents and individuals with special health care needs. As advocates for children’s oral health, the AAPD aims to promote the use of evidence-based policies and guidelines, foster research concerning pediatric oral health, and educate health care providers and the public to improve children’s oral health. For further information, please visit the AAPD Web site at http://www.aapd.org.

2010 JUN 12 – (VerticalNews.com) — According to recent research published in the journal Community Dental Health, “Inequalities in oral health in areas of socio-economic disadvantage are well recognised. As children spend a considerable proportion of their lives in education, schools can play a significant role in promoting children’s health and oral health.”

“However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes were implemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools,” wrote P. Gill and colleagues, University of Glamorgan.

Jun. 7–A three-year effort by the Tacoma-Pierce County Health Department to improve children’s dental health through public school programs failed to make any discernible headway, a new study says.

The School-Based Oral Health Program, used in 10 local school districts from 2006 to 2009, was designed to bring the number of kids with cavities closer to 42 percent — a health benchmark set by the federal government.

But despite the school program, the percentage of Pierce County youngsters with cavities remained high: 56 percent overall and 65 percent for low income children.

There was “no evidence” the program reduced cavities in the total population of children, the Health Department’s internal assessment of the program concluded.

In the program, Health Department staff members examined the teeth of nearly 75,000 second- and third-graders, said David Vance, a Health Department division director. Children without cavities were offered a fluoride varnish or a dental sealant, Vance said. Those with decay were referred to low-cost dental providers.

Several factors contributed to the disappointing results, examiners said. Among them:

–Administrative problems. Only 18 percent of children who qualified for dental treatment received it.

–Failed sealant. Only about half of sealed molars remained fully sealed a year later.

–Economic recession: Tough times might have canceled out improvements

–High mobility: Only 28 percent of students assessed the first year were present for assessment two years later.

The Health Department will continue to explore strategies to prevent cavities in Pierce County children, Vance said.

Officials want to expand the sealant program to more children, find better ways to obtain parental approval and figure out a better way to apply sealants so they stay on molars longer.

Next year, Vance said, local dentists and their staffs will visit the schools instead of Health Department employees.

“We’ve reached out to private providers,” he said. “Rather than having Health Department staff go into the schools, we’ll be the ones coordinating the care. We’ll act as a clearinghouse. We think that will be a much more effective role for us.”

A “Smile Survey,” conducted by the Health Department in 2005, concluded the severity of dental decay was worse in Pierce County than the rest of the state.

In that survey, 37 percent of second and third graders had a history of decay in seven or more teeth (“rampant decay”), compared with 21 percent in all of Washington.

Among low-income preschool children, 39 percent had a history of decay in their upper front teeth, compared with 18 percent in the whole state.

A 2010 Smile Survey has just been finished and the results will be released later this month.

“That should give us a much better idea of where we are with the oral health of kids in Pierce County,” Vance said.

Rob Carson: 253-597-8693 rob.carson@thenewstribune.com

These two clinics routinely absorb the cost of urgent and emergency care for the dentally underserved,” said Gary D. Radine, Delta Dental president and CEO. “We’re pleased that this grant will go directly toward paying for this care. The grant is consistent with our mission to expand access to care for as many people as possible.” About Delta Dental of Pennsylvania Delta Dental of Pennsylvania (www.deltadentalins.com) is part of a holding company system whose affiliated companies, along with Delta Dental of New York, provide dental benefits to nearly 25 million people in 15 states, the District of Columbia and Puerto Rico. They are all part of the Delta Dental Plans Association (DDPA), based in Oak Brook, Ill. DDPA consists of 39 Delta Dental member companies licensed in all 50 states. The association collectively covers nearly 54 million of the 176 million people nationwide with private dental insurance, making it by far the largest national system of dental plans. About the Altoona Regional Partnership and the James W. Barner Community Dental Clinics The Altoona Regional Partnership for a Healthy Community (www.altoonaregional.org) is a 501(c)(3) nonprofit corporation for the Altoona area, which is demarcated as an underserved rural area.

2010 JUN 6 – ( NewsRx.com) — Two community dental clinics that provide much-needed services to low-income people who lack access to care will receive a $10,000 grant from Delta Dental of Pennsylvania (see also Managed Care).

The grant will directly reimburse clinic dentists for their services to patients who have unmet dental needs and who are unable to pay on their own for those services.

The first grant installment of $5,000 was presented Thursday to the James W. Barner Community Dental Clinics of the Partnership for a Healthy Community, which provides oral health care services for those with limited access to care due to medical conditions, disability or limited financial resources. The two clinics collectively serve about 7,500 patients a year, including more than 4,000 children.

The Partnership was created by and operates as an affiliate of Altoona Regional Health System. The children’s clinic is located in and operated in partnership with the Greater Altoona Career and Technology Center.

Although about half of the clinics’ patients are beneficiaries under dental Medicaid or Medicaid Managed Care, many lack any financial resources to help pay for care. The clinic provides these patients approximately $100,000 per year in services such as dental screenings, restorations and emergency care.

“Our clinics are a great story of good people coming together to help neighbors in need,” said Jerry Murray, president and CEO of Altoona Regional Health System. “We have been blessed by the hard work of devoted and community-minded individuals who turned a dream into reality.

“Generous partners such as Delta Dental help us keep the dream alive. And we thank Dr. Donald Betar, clinical director, who was instrumental in securing this grant.”

The clinics serve an eight-county area (Blair, Centre, Huntingdon, Fulton, Bedford, Cambria, Clearfield, and Clinton). They are the area’s largest provider of oral health care services to patients with limited resources.

“These two clinics routinely absorb the cost of urgent and emergency care for the dentally underserved,” said Gary D. Radine, Delta Dental president and CEO. “We’re pleased that this grant will go directly toward paying for this care. The grant is consistent with our mission to expand access to care for as many people as possible.” About Delta Dental of Pennsylvania Delta Dental of Pennsylvania (www.deltadentalins.com) is part of a holding company system whose affiliated companies, along with Delta Dental of New York, provide dental benefits to nearly 25 million people in 15 states, the District of Columbia and Puerto Rico. They are all part of the Delta Dental Plans Association (DDPA), based in Oak Brook, Ill. DDPA consists of 39 Delta Dental member companies licensed in all 50 states. The association collectively covers nearly 54 million of the 176 million people nationwide with private dental insurance, making it by far the largest national system of dental plans. About the Altoona Regional Partnership and the James W. Barner Community Dental Clinics The Altoona Regional Partnership for a Healthy Community (www.altoonaregional.org) is a 501(c)(3) nonprofit corporation for the Altoona area, which is demarcated as an underserved rural area. In 1999, the Partnership and the Greater Altoona Career and Technology Center opened the dental clinics – one for pediatrics and one for adults. Directed by Dr. Donald Betar, the clinics offer free dental screenings, restorations and emergency care for dental Medicaid and Medicaid Managed Care beneficiaries as well as uninsured children and adults and Medical Assistance recipients in Blair, Centre, Huntingdon, Fulton, Bedford, Cambria, Clearfield, and Clinton counties. The clinics serve 7,500 patients a year, including more than 4,000 children.

Keywords: Dentistry, Health Policy, Managed Care, Medicaid, Delta Dental of Pennsylvania.

Socotto P. Garcia was brushing her 17-month-old son Daniel’s teeth when she noticed something wasn’t quite right.

“The color looked a little different on one of the front teeth,” Garcia said. “I started looking to see what was wrong with that tooth.”

Tuesday morning, the Garcia family decided to take Daniel to the Wilson County Health Department to see what was wrong with the tooth.

Turns out little Daniel has a cavity on the back of that front tooth, said Valerie Brock, child public health nurse, after examining him.

The Wilson County Health Department has a new dental screening and fluoride varnishing program called “Into the Mouths of Babes,” which allows parents to bring in children as young as 6 months old to have a dental screening and fluoride varnish applied to the teeth.

The program, which is funded by the state, is for children up to 3 1/2 years of age and the treatments are suggested to be given every six months. The program started March 8.

“Getting the varnish is just like having a fluoride treatment at the dentist,” said Kay Long, child health coordinator. “We just put a very small amount of the varnish on the teeth and it sticks to the teeth until parents brush it off the next day.”

Long said the varnish tastes like bubble gum and the procedure doesn’t hurt the child.

“Children do make a fuss,” Brock said. “But it’s only because they don’t want you to go into their mouth.”

Brock said Daniel cried because he didn’t understand what she was doing.

“His father held him and comforted him,” she said.

Long said the sooner parents bring their children get the varnish, the fewer cavities they will probably have. She said studies show children receiving the procedure have fewer cavity-related treatments in a dental office than children who do not receive the treatment.

Brock said it also helps children to continue into adulthood with dental care when they start early.

Health department officials are trying to get more parents educated about why it is important for children to have regular dental check-ups.

“You would be surprised to know how many children don’t see the dentist,” Long said. “Statistics say 40 percent of children who start kindergarten have cavities.”

Long said many times children come to the health department for their well child check-ups needed to enter school and she finds their teeth and gums are in bad shape.

One reason very young children get cavities is because parents put babies to bed with a bottle.

“Milk has sugars in it and when a baby falls asleep with milk in his mouth, the sugar from the milk sits on the teeth,” Long said. “Toddlers also have sugary drinks in their sippy cups. All of those things cause cavities.”

Access to dental care for some parents is out of reach, Long said.

“There are not many pediatric dentists and only 25 percent of North Carolina dentists participate in Medicaid,” Long said. “So many children don’t get to see the dentist.”

It is not necessary for a child to receive any other health department services to get the dental screening services.

But the parent or guardian of the child must be present when the child gets the varnish.

“It is important that the person who cares for the child be here so they can learn first-hand about cavity prevention and what they can do,” Long said.

Appointments are not necessary. Walk-ins are welcome.

Garcia was brushing her 17-month-old son Daniel’s teeth when she noticed something wasn’t quite right.

“The color looked a little different on one of the front teeth,” Garcia said. “I started looking to see what was wrong with that tooth.”

Tuesday morning, the Garcia family decided to take Daniel to the Wilson County Health Department to see what was wrong with the tooth.

Turns out little Daniel has a cavity on the back of that front tooth, said Valerie Brock, child public health nurse, after examining him.

The Wilson County Health Department has a new dental screening and fluoride varnishing program called “Into the Mouths of Babes,” which allows parents to bring in children as young as 6 months old to have a dental screening and fluoride varnish applied to the teeth.

The program, which is funded by the state, is for children up to 3 1/2 years of age and the treatments are suggested to be given every six months. The program started March 8.

“Getting the varnish is just like having a fluoride treatment at the dentist,” said Kay Long, child health coordinator. “We just put a very small amount of the varnish on the teeth and it sticks to the teeth until parents brush it off the next day.”

Long said the varnish tastes like bubble gum and the procedure doesn’t hurt the child.

“Children do make a fuss,” Brock said. “But it’s only because they don’t want you to go into their mouth.”

Brock said Daniel cried because he didn’t understand what she was doing.

“His father held him and comforted him,” she said.

Long said the sooner parents bring their children get the varnish, the fewer cavities they will probably have. She said studies show children receiving the procedure have fewer cavity-related treatments in a dental office than children who do not receive the treatment.

Brock said it also helps children to continue into adulthood with dental care when they start early.

Health department officials are trying to get more parents educated about why it is important for children to have regular dental check-ups.

“You would be surprised to know how many children don’t see the dentist,” Long said. “Statistics say 40 percent of children who start kindergarten have cavities.”

Long said many times children come to the health department for their well child check-ups needed to enter school and she finds their teeth and gums are in bad shape.

One reason very young children get cavities is because parents put babies to bed with a bottle.

“Milk has sugars in it and when a baby falls asleep with milk in his mouth, the sugar from the milk sits on the teeth,” Long said. “Toddlers also have sugary drinks in their sippy cups. All of those things cause cavities.”

Access to dental care for some parents is out of reach, Long said.

“There are not many pediatric dentists and only 25 percent of North Carolina dentists participate in Medicaid,” Long said. “So many children don’t get to see the dentist.”

It is not necessary for a child to receive any other health department services to get the dental screening services.

But the parent or guardian of the child must be present when the child gets the varnish.

“It is important that the person who cares for the child be here so they can learn first-hand about cavity prevention and what they can do,” Long said.

Appointments are not necessary. Walk-ins are welcome.