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.

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.

Most recently, the Senate version of health reform represents a high water mark for oral health legislation, with more than two dozen important provisions aimed at improving oral health care, which include:

– Expanding insurance coverage for pediatric oral health services and

eligibility for preventive oral health services without co-payments.

– Launching new dental disease prevention initiatives including public

education, school- based sealant programs in all 50 states, and research

grants for dental caries management.

– Addressing critical dental care workforce issues and the cultural

competence and diversity of the provider teams through expanded training

programs and education resources for general, pediatric and public

health dentists and for the exploration of new solutions for dental

professionals to reach rural and underserved areas.

Access issues are particularly severe in many rural and urban communities, and particularly impact children and families of color. The rate of untreated decay in American Indian and Alaska Native children is more than 3 times higher than that of all children in the United States. It is known that those who lack affordable health insurance are at increased risk for unmet dental needs, and together with children from poor and/or minority families, these two categories amount to 52 percent of children in this country.

Untreated dental disease many times leads to serious, life-threatening medical situations. For too long, oral health has long been separated from the rest of the body in most health policy conversations, even though oral health is essential to overall health.

We are pleased that Congress is bringing oral health into the conversation to improve our nation’s overall health. These issues have historically received broad bi-partisan support, and we look forward to continued progress.

The W.K. Kellogg Foundation supports children, families, and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society. Improving oral health for children and families is an important component of our work to improve overall health, eliminate racial disparities in health, and provide needed health care to those who are underserved.

SOURCE W.K. Kellogg Foundation

Credit: W.K. Kellogg Foundation

ADA Launches Community Dental Health Coordinator Pilot Program at Temple University

CHICAGO, Nov. 24 /PRNewswire-USNewswire/ — The American Dental Association (ADA) has signed an agreement with Temple University to train new dental team members as part of a pilot program to improve the oral health in underserved communities.

The Community Dental Health Coordinator (CDHC) is a member of the dental health team who works in communities where residents have limited access to dental care to improve their oral health.

The CDHC provides a limited range of preventive dental care services — including screenings and fluoride treatments. However, of greater importance to these communities, the CDHC will help patients navigate the health system and access care by a dentist or an appropriate clinic and engage in educational activities to improve community members’ oral health habits.

Temple will recruit and train CDHCs from urban locations in Philadelphia over the next two years, returning them to their communities to work as dental team members under the supervision of dentists.

Although the CDHC is a new dental team member whose merits are not yet known, many studies of the community health worker (CHW) model indicate that they can make significant contributions to a community. Because the CDHC will function much like a CHW, the ADA believes that they, too, will have a positive impact on the oral health of their communities through education and outreach.

“We are delighted to welcome Temple’s participation,” said ADA President Dr. Ron Tankersley. “The pilot at Temple will help us understand the effectiveness of a dental health coordinator in underserved urban settings.”

Dr. Amid Ismail, dean of Temple University’s Kornberg School of Dentistry and one of the architects of the CDHC program, explained why the program is seeking to place CDHC trainees in their own communities.

“Our aim is to ensure that the coordinator is able to bridge the gap between local cultures and health care systems. The CDHC can help improve people’s oral health habits and help patients navigate the social and bureaucratic barriers that prevent them from gaining access to available dental health services,” Dr. Ismail said.

Temple is the third of three pilot CDHC program sites. Two other pilot programs are directed by University of Oklahoma, which is training CDHCs from rural areas, and the University of California at Los Angeles, which, in conjunction with Salish Kootenai College in Montana, is training students from American Indian communities.

The ADA has funded the program, which will train six students per site each year.

About the American Dental Association

The not-for-profit ADA is the nation’s largest dental association, representing more than 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly Journal of the American Dental Association (JADA) is the ADA’s flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit the Association’s Web site at www.ada.org.

SOURCE American Dental Association

Credit: American Dental Association

DALLAS, July 30 /PRNewswire-USNewswire/ — Dental benefits are important to overcoming cost concerns that keep Americans from visiting the dentist, a critical step in maintaining oral health, according to a white paper released today by the National Association of Dental Plans (NADP).

Based on its Consumer Survey of more than 6,000 individuals, NADP discovered lack of insurance is the most common reason for not visiting the dentist — seven times more common than fear. In addition people covered by dental benefits have a more positive perception of their oral and overall health.

The Consumer Survey also revealed that individuals with dental benefits are more likely to receive restorative care to maintain their oral health. They are:

– 52 percent more likely to have had a root canal

– 32 percent more likely to have had crowns

– 18 percent more likely to have cavities filled

As well consumers with dental benefits maintain more of their teeth as they are 30 percent less likely to have a tooth extraction

Conversely, respondents without dental coverage are 16 percent more likely to report receiving no basic or major procedures in the last two years.

Based on findings from the Consumer Survey plus a body of industry research and studies, NADP is releasing a white paper Dental Benefits: A Wise Investment in Your Family’s Health. The white paper explores the prevalence of dental disease in children and adults and the role of dental benefits coverage in maintaining oral health. The paper also provides general information about the cost of dental benefits, reasons to have dental coverage and where to find it.

For a copy of the white paper, visit NADP’s consumer Web site, ineeddentalbenefits.com.

About NADP

The National Association of Dental Plans is a non-profit trade association representing the entire dental benefits industry, including dental HMOs, dental PPOs, discount dental plans and dental indemnity products. NADP’s member dental plans provide dental benefits to approximately 140 million of the 170 million Americans with dental benefits. NADP’s members include major commercial carriers, regional and single-state companies.

Recently my wife, Dilly, got an estimate for a new pair of prescription sunglasses. As much as we like our optometrist, $400 for basic frames and tinted bifocal lenses just wasn’t in our budget — not with our daughter about to start college. So Dilly headed to Costco, where she paid $209 for similar frames and the same prescription. Costco even threw in a scratch-resistant coating — about a $40 surcharge from our optometrist. Total savings: $231.

[Photograph]: $3,597 Average a person with employer insurance spends on health care
Photographs: Fancy Photography/Veer; LARA ROBBY/STUDIO D (tag).

These days, we’re all feeling squeezed when it comes to health costs — and we’re all looking for ways to save. Certainly, it’s an imperative for the 47 million who have no health insurance at all. But it’s also the case for people like Dilly and me, who are self-employed and buy our own health insurance, as well as for the 159 million Americans who are covered through their employer. This year, the average employee on her company’s group plan will still pay $3,597 in health-care costs, $331 more than in 2007, reports Hewitt Associates, a human resources company. Just over half of that — $1,859 — will go to her share of insurance premiums, with the rest covering deductibles and co-pays for doctor visits, lab tests, and X-rays, as well as prescription drugs and services that are not included in the health plan, such as dental care and eyeglasses. Here are 15 cost-cutters that can put a big chunk of that money back in your wallet.

1 ask for a freebie

If you’re starting a new drug regimen, see if your doctor can give you a sample or a starter kit. That way, you can check whether the medication works for you — and doesn’t cause severe side effects — before you invest in a month’s supply.

2 don’t bypass your doc

Now that many health plans don’t require a referral to see a specialist, it’s tempting to skip the primary-care physician and go right to the dermatologist for a rash or to the orthopedist for a sprained ankle. But you may not need the specialist — or his higher co-pay. “Insurers may charge as much as double [$30 versus $15 for a co-pay] to see a specialist,” says Mila Kofman, superintendent of insurance for Maine.

3 focus on the web

A recent eBay search turned up 2,950 pairs of eyeglass frames, including Dolce & Gabbana ($79.99; retail, $125) and Gucci ($79; retail, $305). Try on frames at an optician’s first, then look for the same or similar ones to buy online. You can also find reading glasses at numerous Internet retailers. Bargains include three pairs of magnifiers for $9.99 at 4readers.com, as well as colorful hand-painted frames for $6.99; peepers.com carries a menagerie of animal-print readers starting at $10.40 per pair. Ordering contacts from an Internet retailer like AC Lens (aclens.com ) can save you up to 30 percent on popular brands. A box of Bausch & Lomb’s Softlens 38, which retails for $20.95, goes for $14.95 in an online four-box order.

4 check out a discount card

Enroll in one of these plans and you get a hefty chunk off on care from participating dentists, doctors, and even hospitals. For example, Vital Savings, a plan from Aetna, offers savings of 50 percent on eye exams and 15 to 50 percent on dental care for a onetime sign-up charge of $15 and a monthly fee of $10.50 for a family. Be careful: The discount-health-card industry has attracted scam artists. Before signing up, try to check out the plan with your state insurance commission (Google the name of your state, followed by “insurance commission”). And if you’re especially attached to your doctors, ask whether they participate in any discount plans.

5 stay covered

If you leave a job, you have the right, by law, to continue participating in your company’s group health plan for up to 18 months. The program (COBRA) is expensive — up to 102 percent of the cost of the policy, all of which you’ll pay yourself. But it’s cheaper than taking out a comparable private policy or than getting sick without insurance. Also, if you stay insured, your next employer can’t deny you coverage because of a preexisting condition, explains Randy Boyle of the National Health Law Program. (Some states limit what employers can do, so check first.)

6 take advantage of kid programs

Even if you can’t swing insurance right now, every state provides health coverage and medical care to infants, children, and teens whose family income falls under certain levels. For information, call 877-543-7669 or visit insurekidsnow.gov.

7 shape up

The simplest way to save money on health care is to stay well. Women who are extremely overweight have annual medical costs that are nearly 70 percent higher than normal-weight women, a study in the American Journal of Health Promotion found. Not fazed? Some employers, including Kellogg and Clarian Health, reward fit employees with reduced insurance premiums or deductibles (or other bonuses), while their less-healthy coworkers continue to pay the full amount. At the Bank of Geneva in Indiana, for example, employees who choose to participate in the plan can earn up to $2,000 a year in supplemental insurance reimbursements.

8 get a pro in your corner

When you’ve just been through a major illness, you may not have the strength to take on the medical establishment by yourself; a medical billing advocate can do it for you, getting you coverage when your insurer says no or reducing an exorbitant doctor or hospital fee. “We know the medical coding and billing guidelines and will intercede on your behalf,” explains Nora Johnson, vice president of education and compliance for Medical Billing Advocates of America, a trade organization. These services charge by the hour ($25 to $75, depending on their location) or take a percentage of what they collect for you, usually between 20 and 35 percent. For more info, check billadvocates.com (and see “Saved $17,336,” page 48).

9 go to dental school

Most have low-cost clinics for the public. Relax (and open wide) — the people wielding the drill are third- and fourth-year students, and they’re supervised. Savings can be considerable: At the Ohio State University College of Dentistry, for example, a cleaning might be $53 to $65, compared to $75 to $90 for a Columbus-area dentist. A typical crown ranges from $450 to $700 at the clinic versus $800 to $1,110 in a private practice. To see if there’s a dental school near you, go to the American Dental Association’s Web site (ada.org) .

10 say bye-bye to brand names

Sure, choosing a generic drug over a brand name can save you lots of money — depending on what you take, you could enjoy a 52 percent cut in the daily cost of your medications, reports the FDA. But now there’s another reason to go generic: Fill your Rx at one of the big-box retailers like Wal-Mart, Target, or Kmart, and you can get a month’s supply for as little as $4 or a 90-day supply for $10 to $15. Costco doesn’t have a monthly plan but does offer major savings. Or join the Walgreens prescription savings club: For a $35 annual fee, families can save significantly on more than 5,000 medications, including many generics available in three-month supplies for $12.

11 sign on for wellness

You may be able to cut health-care premium costs — sometimes by hundreds of dollars — by participating in wellness programs at your job. Almost half of large companies now offer or plan to offer cash rewards or credits toward premiums to employees who meet certain healthy criteria for body mass index, take steps to lower blood pressure and cholesterol, or work out regularly.

12 cut your co-pays on drugs

For prescription medications that you take regularly, ask doctors if they can write an Rx for a three-month supply. You’ll make only one co-pay instead of three. And if you don’t have drug coverage, consider ordering a 90-day supply of meds online. Drugstore.com advertises savings up to 75 percent over average retail drugstore prices; on a 90-day supply of Ortho Tri-Cyclen Lo, for example, you’ll save about $20.

13 get the best insurance deal

When it comes time to renew their health coverage, some 60 percent of employees just take the company’s default plan or check the “same as last year” box, reports Hewitt Associates. That can be a costly mistake. If you and your husband are both eligible for health insurance through work, for example, it may be cheaper for one of you to take an individual policy and put the rest of the family on the other company’s plan. Too much math? Your employer may have a Web-based tool to help you figure it out — or you can speak to the staff in human resources.

14 visit your drugstore’s clinic

If you’d have to pay full freight for a doctor’s appointment, or it’s a weekend and using an ER would set you back a chunk per your insurance plan, in-store health centers can be a bargain. Located in many branches of CVS, Target, Wal-Mart, and other retailers, these clinics treat insect bites, minor wounds, ear and sinus infections, and other routine problems. They also administer vaccinations. Fees run about $40 to $65, depending on location and treatment (flu shots are often much less).

15 pay up front

Some doctors are willing to provide a discount to patients who can fork over the whole fee at the time of treatment, research from Georgetown University’s Health Policy Institute found. This was particularly true in cases where patients had seen the physician previously and now didn’t have insurance, says Mila Kofman, formerly an associate research professor at the institute. Even hospitals may negotiate a lower rate for uninsured patients who pay right away. The downside, of course, is that you have to cover the entire bill; you can’t go on a payment plan. (This practice may be referred to as “paying in cash,” but it doesn’t literally have to be cash; you can write a check or possibly use a credit card.)

FREE SCREENINGS

VASCULAR DISEASE The Society of Interventional Radiology supports free tests for peripheral arterial disease in September. Info: legsforlife.org.

DEPRESSION Confidential screenings, sponsored in part by Mental Health America, are held at 1,500 hospitals and other sites during October. Info: mentalhealthscreening.org.

MEMORY The Alzheimer’s Foundation of America sponsors an anonymous National Memory Screening Day each November. Info: nationalmemoryscreening.org.

HEART DISEASE Sister to Sister, a foundation devoted to preventing heart disease in women, offers cholesterol and blood pressure tests in at least 19 cities in February. Info: sistertosister.org.

SKIN CANCER Numerous centers have free skin checks, generally in May, many through the American Academy of Dermatology. Info: aad.org; click on “skin cancer information and screenings.”

ASTHMA Screenings, under the auspices of the American College of Allergy, Asthma & Immunology, are available at more than 250 sites; most take place in May. Info: acaai.org; click on “patient education.”

How They Saved

SAVED $4,944/YR

Annemarie Marek, of Dallas, saw her health-insurance premiums jump to $632 a month. So she switched to a plan with a high deductible, agreed to use doctors in a preferred-provider organization, and joined the Y. New premium: $220 per month.

SAVED $17,336

Tina Goldstein, of Chicago, was billed nearly $36,000 for surgery she’d been told would be half that — the rate changed largely due to insurance issues. So she turned to Medical Recovery Services, which negotiated the bill to under $10,000; even after paying MRS’s fee (in her case, about $8,600), Goldstein came out $17,336 ahead.

SAVED $210/YR

Melinda McGinnis, of Brownsburg, IN, was paying $35 a month for a 10-mg dose of Crestor. Now, through her insurer’s half-tablet program, she buys the 20-mg dose and, with a tool from the drugstore, splits the pills, saving $35 every two months. “It’s a nice dinner out,” she says.

CHEAPER RX

DRUGS NOW (OR SOON) GOING GENERIC

Fosamax For osteoporosis; generic: alendronate sodium

Ambien For insomnia; generic: zolpidem tartrate

Pravachol To lower cholesterol; generic: pravastatin sodium

Prevacid For gastric-reflux disease; generic: lansoprazole

Lamisil For fungal nail infections; generic: terbinafine hydrochloride

Norvasc For high blood pressure; generic: amlodipine besylate

NOW OVER THE COUNTER

Zyrtec For allergies

MiraLAX For constipation

A Freebie That Saved Her Life

As far as Kristin Passath knew, she was in perfect health. The Tampa events planner and mom of two wasn’t overweight, and she exercised regularly. But on a whim, when she was in Miami on business in February 2007, she went to a free health fair sponsored by Sister to Sister. There, she was shocked to learn that her blood pressure was a scary 152/92 — making her a candidate for a stroke or heart attack. “How could that be?” she wondered. “I’m only 36.” Still, Passath delayed checking it out with her doctor. Then, when she learned about the dangers of high blood pressure, she decided to see a cardiologist. He put her on two medications and suggested changes in her diet and workout routine. Today her blood pressure is a healthy 120/78.

SMART SWITCH

Similar Drug, Lower Price

If your brand-name prescription is not available in a less expensive generic form, you might be able to take a comparable drug that is sold generically. Or you may be able to switch to an OTC product. Check with your doctor.

“Further studies need to be done but our findings show that dental treatment had a protective effect on adverse birth outcomes in women who sought dental treatment,” said David A. Albert, DDS, MPH, Director, Division of Community Health, College of Dental Medicine, Columbia University.

When comparing the group who did not receive any dental treatment to the groups that received gum treatment and dental cleaning, the study found:

– The preterm birth rate was 11.0 percent for those not receiving dental treatment, and 6.4 percent for those receiving treatment

– The low birth weight rate was 5.4 percent for those not receiving dental treatment and 3.6 percent or lower among the groups receiving treatment

The Institute of Medicine of the National Academies determined that premature births, meaning babies born at less than 37 weeks of pregnancy, cost at least $26 billion a year and represented 12.5 percent of births in the U.S. in 2005.

“The results of this study send a strong message about the importance of dental care for women who want to start a family,” said Dr. Mary Lee Conicella, DMD, FAGD, National Director of Clinical Operations, Aetna Dental. “We are seeing evidence that supports the role of routine preventive dental care in helping to protect the health of the newborn and the mother and contributing to lower associated medical costs.”

Aetna provides educational information about the importance of good oral health to women who are planning to become pregnant, as identified in responses to its Health Risk Assessment tool. Aetna also provides a dental/medical integration (DMI) program to pregnant women and at-risk members with diabetes and cardiovascular diseases who have both Aetna dental and medical coverage. The program is comprised of enhanced benefits, including an extra cleaning, full coverage for certain periodontal services and a variety of outreach methods to at-risk members who are not currently seeking dental care. As a result of various outreach methods during a two-year pilot with 500,000 Aetna members, 63 percent of those at-risk members who had not been to the dentist in 12 months sought dental care.

“The findings from this latest study we conducted continue to show that members with certain conditions who are engaged in seeking preventive care, such as regular dental visits, can improve their overall health and quality of life,” said Alan Hirschberg, head of Aetna Dental.

Aetna Dental launched its DMI program last fall following a published research analysis it conducted with Columbia University College of Dental Medicine which found that high-risk individuals that sought earlier dental care lowered the risk or severity of their condition and subsequently, lowered their overall medical costs.

About Aetna Dental

Aetna Dental is one of the nation’s leading providers of integrated and stand-alone dental products, serving more than 14 million dental members. Aetna Dental has also established itself as a leader in the research and execution of dental/medical integration programs. It launched its own program in 2006, which includes enhanced benefits and educational outreach to members to help them achieve optimal health.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 37.2 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. www.aetna.com

Now, at long last, he sat in the blue exam chair in the Southwest Baltimore office of Dr. Larry Bank, a cramped space with a bucolic wallpaper scene of a waterfall. At 45, Bennett is trying to restart his life. That means getting a grip on his addiction through a residential rehab program — and fixing his ragged mess of a mouth.

Time to lose the jack-o’-lantern look. The man in the blue jeans and gray hoodie wants to smile again without embarrassment.

“I’m nervous,” he said with a slight lisp as Al Greene’s crooning floated from a boom box. Doletta Thomas, Bank’s effervescent assistant, assured him he had no need to fret. Today was just a preliminary step toward removing four wobbly lower teeth and the root remnants of 24 others, so he could get dentures.

Before Bank even peeked inside his patient’s mouth, the dentist did something remarkable: He handed him his home phone number for after-hours emergencies. As he jovially put it, “it’s a journey we’re going to be going on together.”

Larry Bank knows journeys. He’s been on one for 36 years. It started right after graduation from the University of Maryland Dental School, when he set up shop in an empty dental office in a poor neighborhood nearly 20 blocks west of Camden Yards.

Ever since, he’s been catering to the dental needs of people with few if any options. Some of his patients are prostitutes or drug addicts. Close to a quarter have HIV and the mouth problems the virus can foster. Many are retirees struggling just to pay their electricity bills. All are poor.

“It breaks your heart,” he said of the desperation he sees. “You just keep trying.”

Bank is a lanky man of 62 with a mustache and thinning hair. His shoulders slump a bit as he glides between the two exam rooms in tasseled loafers, chit-chatting and projecting enthusiasm. He uses words like “crazy” and “stupid” to describe the financial aspects of his practice. He praises his wife, Lana, for putting up with a schedule that has him treating patients Saturdays and Sunday mornings.

But he also says, mantra-like, that “it’s fun.”

Oral health care for adults in Maryland is “atrocious,” he says. The Medicare program for the elderly does not cover dentistry. While the state-federal Medicaid program for the poor provides dental coverage for children, it does very little for adults.

A bad mouth can cause major problems. It can kill a person’s confidence. It can cost someone a new job. It can lead to grave medical woes and even death. Last year, a 12-year-old Maryland boy named Deamonte Driver died after a tooth infection spread to his brain. His death spurred efforts to boost children’s dental care.

Bank is not the only dentist committed to treating low-income adults, and adult programs exist here and there. But Bank’s single-focused dedication has won him admirers at high levels.

“He’s in rarefied air; he really does care,” said Dr. Harry Goodman, director of the state’s Office of Oral Health. “He feels it’s his mission. I don’t know where it comes from.”

Where it comes from, Bank says, is his Uncle Sam — Dr. Samuel Rubin, a doctor who made house calls with his little black bag. On Christmas morning, young Larry would tag along on patient visits. The emotional bond between the healer and the healed made a lasting impression. And Uncle Sam left Bank an inheritance that has effectively subsidized his years of charitable dental care.

Some of Bank’s patients have dental coverage through the state’s Division of Rehabilitation Services. The federal government pays Bank for seeing HIV-positive patients under the Ryan White Care Act. A salesman at the Sullivan-Schein dental supply company donates materials.

But Bank figures that of the 51 patients he saw Wednesday at his office at 2116 W. Pratt St., two-thirds paid nothing or lacked coverage for what they needed. Even the fees he does charge are low compared to most dentists’. He’s happy to get just $250 for a set of upper and lower dentures, including five dental visits.

Still, he has to earn a living and pay wages to the close-knit office staff, which is made up of two sisters and a mother and daughter. So he asks patients to pay what they can, if they can.

“If we end up even, it’s a good day,” Bank said with a shrug. “Usually we’re a little behind.”

That doesn’t stop him from handing out food coupons that he buys for redemption at nearby Kim’s Grocery and springing for antibiotics and pain medicine at a neighborhood pharmacy.

Shelly Koerick, 29, traveled all the way from Dundalk to see Bank at a friend’s urging. She was among those headed for the surgeon. Two abscessed teeth needed to go.

“Thank you so much, Dr. Bank,” she said as she rose from the chair. “God bless you.” Threading through the waiting room packed with eight more patients, she exclaimed: “They should have a bigger place for the man with a big heart!”

“Sweet,” Bank replied as he led her to a taxi.

In a minute he was back in the exam room where 66-year-old William Jackson awaited. A couple of years ago his upper dentures broke. He’d been resigned to eating soft food until he heard Bank would not deny him for lack of money.

Bank examined the dentures. An easy fix.

“I’ll get these back by Saturday,” Bank said.

“OK.”

“Don’t worry. Just knock on the door Saturday.”

Controllers who explore this approach to dental benefits acknowledge that dental benefits are relatively inexpensive. Proof: According to Mercer, the per-employee cost for dental coverage averaged $692 last year, up 10 percent from 2006’s average cost of $629. This is significantly less than the cost of health benefits, which was $7,983 per employee in 2007. Key point: While the per-employee cost of dental benefits rose $63 last year, the cost of health benefits jumped $460.

CR emphasizes that the percentage of companies that are making their dental insure nee voluntary is small. Proof: According to a recent survey from the National Association of Dental Plans (NADP), only ?7 percent of employers with fewer than 50 employees are making dental benefits available to employees at their own cost. Furthermore, only 5 percent of large organizations-those with 10,000 employees or more-offer these benefits voluntarily.

At the same time, there is budgetary logic to a voluntary approach. Explanation: According to the most recent MetLife Employee Benefits Trends Study, dental coverage is only the fifth most popular benefit, following medical, vacation, pensions, and prescription drug coverage. Meanwhile, the rising cost of health benefits is forcing some employers to redeploy their limited benefit dollars toward medical premiums. Key point: According to NADP, 18 percent of all organizations say they are likely to change dental coverage to a voluntary benefit.

In the meantime, most employers continue to pay the lion’s share of dental coverage costs. According to Mercer, for example, 78 percent of organizations required employees to contribute to the cost of employee-only coverage in 2007, while 87 percent required a contribution forfamily coverage. Here, the average monthly contribution for employee-only coverage was $17, or 56 percent of premium. Meanwhile, the average monthly contribution for family coverage was $51, or 59 percent of premium. At the same time, the median deductible for dental plans was $50 last year, unchanged since 1997. Additional information from Mercer about the cost of dental coverage includes:

* For individual dental coverage, costsharing benchmarks include median annual maximum benefit, $1,250, and median lifetime maximum orthodontic benefit, $1,500.

* Eighty-eight percent of dental plans include an individual annual maximum benefit per year for preventive and restorative care. Here, the most common maximum benefits are $1,000 (37 percent of employers) and $1,500 (32 percent). Only 4 percent of employers have a maximum that is less than $1,000.

* Only 13 percent of organizations bundle dental benefits with their medical plans. These tend to be smaller employers looking for simpler administration and more favorable rates.

* In 2007, employers shifted to dental preferred provider organizations (PPOs) and dropped health maintenance organizations (HMOs). Details: The use of PPOs by dental plan sponsors jumped to 73 percent in 2007, up from 67 percent and 61 percent in the two previous years. At the same time, the percentage of employers offering dental HMOs fell from 17 percent to 15 percent in 2007.

Background: The low usage of dental HMOs has several causes. These include narrower HMO networks, which hamper access to providers, and HMO plan design, which is less flexible than PPOs and more resistant to cost-saving adjustments. Adds Mercer, “While it is generally less expensive to cover an employee through an HMO than a PPO, administration fees for dental HMOs, as a percentage of the total premium, are often relatively high.”

Attorney Al Gaudio met with council behind closed doors prior to a Wednesday business meeting.

Gaudio told council the authority agreed to a plan that will end ongoing litigation….

Gaudio was hired after council voted to dissolve the authority and take over the Mon Valley Community Health Center properties and related assets….The authority has long owned and…operated the health center and annex.

The city sued to challenge severance packages for authority employees.

The package originally called for authority Executive Director Larry Bender and building Superintendent Tom Wilkinson to receive one year of salary and medical and dental coverage should the authority be dissolved.

Gaudio said…the settlement calls for a $128,058 combined payout for the employees, or half of…their combined annual salaries. The original severance package…called for a $256,000 combined payout.

Gaudio said he expects the deal to close the week of Dec. 1, at which time the city will be poised to take over the properties and the assets. The authority is losing $20,000 a month, Gaudio said.

Mayor Anthony Petaccia called the timing of the settlement a “miracle,” but warned that the financial situation is still “not out of the water.”

“We’re all praying this will work, but we still have tough decisions to make,” Petaccia said.

As council discussed the settlement, about 30…residents, including many police officers and streets and code enforcement employees, waited to hear news of layoffs.

The mayor had a motion for layoffs on the agenda.

Petaccia said council discussed behind closed doors how many employees to furlough.

“First it was seven, then five, then two, but we only had enough votes for two,” the mayor said. “If we did have the votes, it was for only one or two…employees. One or two…isn’t going to accomplish anything,…and your singling a couple individuals.”

The mayor did not rule out future furloughs.

Petaccia said that when council learned about the settlement, it…started working on alternative plans.

The mayor said the tentative plan is to shift some employees to the health center properties to handle maintenance. Petaccia and Councilman John Harhai hope to make plans to move city operations to the health center annex to reduce monthly expenses.

“I believe, now, we are a lot closer to moving to that building; at least I hope so,” Harhai said of the annex. “This all happened in the last 45 minutes, and we are very, very grateful, and I hope this is a step in the right direction.”

Councilman Josh Retos said Gaudio far exceeded expectations.

“We would unfortunately be in a situation where we would have to lay off employees,” Retos said. “He did come in and save us.”

Councilman Jeff Gagatko said council will meet with nonuniform employees union to discuss job shifts. He expressed hope the union will work with the city.

Gagatko commended his colleagues for working together.

“Often times this council is an example of what government is at its worst — when we are fighting and arguing,” he said. “This evening, we are an example of what government can be at its best, by coming together, putting our heads together, and doing…what’s best for the community, and in this case, our employees.

“I understand there is still a 5-mill tax increase that everyone in the community will have to deal with. But we are fortunate this evening to be able to prohibit the layoff of city employees, and for that, I have to credit my colleagues.”

Petaccia apologized to the employees for “stress” they endured over the past eight months as council mulled layoffs.

Police officer James Quattro thanked council for avoiding layoffs.

He said the past several months have been stressful as rumors circulated about who would be furloughed. Quattro said that if the future does include layoffs, he hopes council will consider the effect of cutting the police force.

“I’m not saying anyone’s job is less important, because I don’t want to see anyone lose their job. But we are down three police officers, and I think things need to be looked at a lot more in depth,” Quattro said.

Quattro asked council which two employees had been marked for layoffs, but Petaccia declined to identify the workers.

Steve Beck, president of the non-uniform employee union, thanked council.

Beck said he would meet with Councilman Wayne Doptis after the meeting to discuss why the bargaining unit has yet to sign off on its contract. The three-year pact was approved last November, but officials from the American Federation of State, County and Municipal Employees union have never signed the contract.