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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

Type of medicine: anesthetic; nerve block

Generic and brand names: articaine/epinephrine, injection; Septocaine

What is this medicine used for?

This medicine is given by injection to cause loss of feeling before and during surgery, dental procedures (including dental surgery), or labor and delivery.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• asthma
• heart disease or blood vessel disease
• high or low blood pressure
• kidney or liver disease
• myasthenia gravis
• seizures
• thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider’s approval.

How do I use it?

This medicine is given by a healthcare provider or dentist trained in the use of local anesthesia.

What should I watch out for?

This medicine may cause lightheadedness, dizziness, drowsiness, or numbness. Do not drive or operate machinery unless you are fully alert.

Since this medicine stops all feeling on your skin, be careful not to injure your skin by scratching, rubbing, or exposing it to extreme hot or cold temperatures. If you have received an injection in your mouth, do not chew gum or food while your mouth feels numb. The numbing effect of the medicine goes away after a few hours.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat), seizures.

Serious (report these to your healthcare provider right away): Irregular or rapid heartbeat; shallow breathing; seizures; unusual weakness or tiredness; nausea; vomiting; ringing in the ears; slurred speech; sudden change in vision; sudden change in behavior; tremors.

Other: Constipation, diarrhea, shivering, tingling, blurred vision, dizziness, headache, restlessness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• barbiturates such as phenobarbital (Solfoton), butabarbital (Butisol), pentobarbital (Nembutal), and secobarbital (Seconal)
• haloperidol (Haldol)
• hyaluronidase (Amphadase, Vitrase)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) (Do not take an MAO inhibitor and this medicine within 14 days of each other)
• other anesthetics such as lidocaine (Lidoderm Patch)
• phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), prochlorperazine (Compazine), and thioridazine
• St. John’s wort
• sleeping pills such as triazolam (Halcion), zolpidem (Ambien), and temazepam (Restoril)
• tranquilizers such as diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and alprazolam (Xanax)
• tricyclic antidepressants such as amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and doxepin (Sinequan)

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

____________________________________________________

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.
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To help prevent tooth decay and gum disease, practice proper brushing and flossing and see your dentist regularly. Ask your dentist or dental hygienist to show you proper brushing technique. Also, you may want to ask your dentist about additional ways to prevent tooth decay, such as sealants for teeth and fluoride treatments.

Brush your teeth correctly for at least 2 minutes at least twice a day. The most important time to brush is before you go to sleep. It is also a good idea to brush or rinse after meals. Floss between your teeth once a day.

Brushing your teeth

The American Dental Association suggests that you brush your teeth in the following manner:

• Position the head of the toothbrush against your teeth, with the tips of the bristle angled against the gum line at a 45-degree angle.
• Move the brush in a gentle, circular scrubbing motion. Brush the outer surfaces of each tooth, upper and lower, keeping the bristles angled against the gum line.
• Use the same motion to brush the inside surfaces of the teeth.
• Scrub chewing surfaces of all teeth. Only the tips of the bristles on the toothbrush can clean the teeth. Use a light pressure so that the bristles do not bend. Let the bristles reach into the grooves of the teeth. Change the position of the toothbrush often.
• To clean inside the front teeth, tilt the brush vertically and make gentle up and down strokes with the front part of the brush over the teeth and gum tissue of the upper and lower jaws.
• Brush the tongue to refresh your breath and remove bacteria.

A brush with soft, end-rounded or polished bristles is less likely to injure gum tissues than one with hard bristles. A brush with hard bristles can cause abrasion to the teeth. Abrasion is the wearing away of the tooth structure, especially along the gumline. Abrasions make it easier for bacteria and acids to damage the tooth because the hard, protective enamel layer has been brushed away. The hard bristles can also cause damage by making the gum line recede (push back) away from the tooth.

Replace your brush at the first sign that the bristles have become splayed or matted. Store your brush uncovered in a dry place so that it can dry out between brushings. Never share your toothbrush with anyone. It contains bacteria that can be passed from one person to another no matter how well you clean the brush.

Some electric toothbrushes can clean better than manual brushes. People with handicaps and young children may find an electric toothbrush easier to use. Ask your dentist which type of brush will clean your teeth more effectively.

Flossing your teeth

Flossing is the best way to remove food and plaque from between the teeth, an area the toothbrush cannot reach. Use the following technique:

• Cut off about 18 inches of floss and wind most of it around the middle finger of one hand. Wind the rest around the middle finger of your other hand, to take up the floss as you use it.
• Gently, using a sawing motion, pull the floss between 2 of your teeth, being careful not to snap it into the gums.
• When the floss reaches the gum line, curve it into a C-shape against one tooth and slip it into the space between the tooth and the gum until you feel resistance.
• Holding the floss tightly against the tooth, move it up and down away and toward the gum, scraping the side of the tooth.
• Wind the floss around the middle finger, so that a fresh section is in position and repeat for all teeth. Not using a fresh section of floss can spread bacteria and could cause a gum infection (gingivitis).
• Remember to floss the backs of your rear 4 teeth.

If you keep having bleeding from your gums, it is a sign that something is not healthy. It should be looked at by your dentist if it continues for more than 5 days.

Buying dental products

Look for the American Dental Association (ADA) seal of acceptance when determining the effectiveness of a product.

Always buy toothpastes with fluoride. The fluoride helps prevent cavities. You can buy toothpastes with special ingredients for controlling tartar or for whitening teeth.

Mouthwashes are generally used to temporarily freshen bad breath. Some mouthwashes may help reduce plaque levels. Fluoride mouthwashes also help protect the teeth against decay. If your breath odor is not caused by food, such as garlic or onions, it may be a warning sign of decay, gum abscess, or a medical problem. Ask your dentist to determine why you have bad breath.

Preventing decay with a healthy diet

Decay occurs only when the inside of the mouth is acidic. This happens when you eat starchy or sugary foods (carbohydrates). You can help prevent decay by avoiding highly sugary or sticky foods or brushing your teeth right after you eat these foods. Rinsing with water after you eat or drink sugar-containing foods can also help reduce the amount of acid and help wash away food plaque from the teeth.

Snacks to avoid include:

• candy, cookies, cake, pie
• soda pop and other sugary liquids
• gum sweetened with sugar, including high fructose corn syrup
• crackers, breadsticks, chips
• dried fruits; raisins are not only sweet but also sticky and cling to the teeth.

Snacks to choose include:

• fresh fruit (However, because some fruit, such as oranges, pineapples, and peaches, are high in natural sugar and acid; frequent fruit snacks may damage your teeth. It is best to rinse your mouth with water after eating these fruits and not brush your teeth until 45 minutes after you ate the fruit.)
• fresh vegetables
• cheese
• unsalted nuts
• unsweetened fruit juices
• popcorn (unsalted)
• hard-boiled eggs
• bean dips.

A healthy diet is the cornerstone of dental health. A diet rich in fresh fruits and vegetables and whole grains is healthy for teeth and gums. Foods such as raw apples help clean the teeth and make good snacks. Milk is a good snack and a good mealtime drink. Drink it with sweet foods to help wash sugar from your mouth.

Chewing sugarless gum after meals promotes production of saliva, a natural mouth rinse, and helps neutralize tooth-decaying acids in plaque. It is good to brush your teeth after eating, but if you can’t, chewing sugarless gum is an alternative. Chewing gums sweetened with Xylitol can reduce and control the amount of bacteria that cause decay.

Dental care during pregnancy

Women who are pregnant may notice that their gums are swollen and bleed when they brush or floss their teeth. The bleeding is usually related to the increased blood flow to the gums caused by hormonal changes during pregnancy. The increased bleeding usually goes away after delivery. In the meantime, be sure to floss every day and brush your teeth with a soft toothbrush. You can use a mouthwash that has no alcohol or use just warm water to cleanse your mouth and gums.

Try to visit the dentist at least once during your pregnancy to have your teeth examined. Tell the dentist that you are pregnant. Most dental work can be done safely while you are pregnant, but some procedures and treatments may need to be postponed until after pregnancy. It may be a good idea to have your dentist call your pregnancy healthcare provider to help determine which tests and treatments are safe for you. Antibiotics, pain medicines, or even X-rays are often necessary for some special dental problems during pregnancy. Your dentist can consult with your pregnancy healthcare provider before proceeding with treatment.
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