Now that has to go as well. Because I could not floss and clean properly under the bridge and between the supporting crowns, I developed a severe periodontal infection.

Dr. Michael Zidile, the young periodontist I consulted, took one look at my mouth and said: “This is not how we do restorations nowadays. A bridge is not a permanent solution and makes it too hard for most people to keep their gums and underlying bone healthy. Now we do implants and individual crowns where needed.”

The healthcare reform bill introduced before the U.S. Senate would extend dental care to millions of uninsured children, originate new oral health monitoring, and train new midlevel providers in pilot programs.

The largest Change is a provision that all health insurance plans would provide dental insurance for all children.

The Senate bill includes would prohibit plans in the exchanges from requiring copayments or any other type of "cost sharing" for preventive services.

Children could get services such as cleanings, exams, consultations, fluoride treatments, and sealants without having to pay anything above their health insurance premiums.

If there are no further changes, the following benefits would apply:

• In a new "Public Health Services Track," the government would pay the tuition of at least 100 dental students a year, in exchange for their commitment to work with underserved populations.
• All Dental examination chairs and x-ray machines would have to be handicapped accessible within two years.
• The U.S. Centers for Disease Control and Prevention would start a five-year oral health care prevention campaign with an emphasis on community water fluoridation and dental sealants.
• The CDC would provide grants to research methods of managing tooth decay.
• Grants totaling $30 million for 2010 and "such sums as may be necessary" until 2015 would be authorized for schools that train general, pediatric, or public health dentists and dental hygienists.
• In a new "Public Health Services Track," the government would pay the tuition of at least 100 dental students a year, in exchange for their commitment to work with underserved populations.

• Grants would be issued for each of 15 "alternative dental health care providers demonstration projects."  This would provide therapists for children who wouldn't be dental school graduates.
• The “midlevel providers” could be community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians, dental therapists, dental health aides, or some new classification. They would be evaluated for their ability to "increase access to dental health care services in rural and other underserved communities."

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

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Information for making good healthcare decisions.

Keeping informed is your best protection.                            

WSJ NOVEMBER 19, 2009

A Breast Cancer Preview

The mammogram decision is a sign of cost control to come.

A government panel's decision to toss out long-time guidelines for breast cancer screening is causing an uproar, and well it should. This episode is an all-too-instructive preview of the coming political decisions about cost-control and medical treatment that are at the heart of ObamaCare.

As recently as 2002, the U.S. Preventative Services Task Force affirmed its recommendation that women 40 and older undergo annual mammograms to check for breast cancer. Since regular mammography became standard practice in the early 1990s, mortality from breast cancer—the second leading cause of cancer death among American women—has dropped by about 30%, after remaining constant for the prior half-century. But this week the 16-member task force ruled that patients under 50 or over 75 without special risk factors no longer need screening.

So what changed? Nothing substantial in the clinical evidence. But the panel—which includes no oncologists and radiologists, who best know the medical literature—did decide to re-analyze the data with health-care spending as a core concern.

The task force concedes that the benefits of early detection are the same for all women. But according to its review, because there are fewer cases of breast cancer in younger women, it takes 1,904 screenings of women in their 40s to save one life and only 1,339 screenings to do the same among women in their 50s. It therefore concludes that the tests for the first group aren't valuable, while also noting that screening younger women results in more false positives that lead to unnecessary (but only in retrospect) follow-up tests or biopsies.

Of course, this calculation doesn't consider that at least 40% of the patient years of life saved by screening are among women under 50. That's a lot of women, even by the terms of the panel's own statistical abstractions. To put it another way, 665 additional mammograms are more expensive in the aggregate. But at the individual level they are immeasurably valuable, especially if you happen to be the woman whose life is saved.

The recommendation to cut off all screening in women over 75 is equally as myopic. The committee notes that the benefits of screening "occur only several years after the actual screening test, whereas the percentage of women who survive long enough to benefit decreases with age." It adds that "women of this age are at much greater risk for dying of other conditions that would not be affected by breast cancer screening." In other words, grandma is probably going to die anyway, so why waste the money to reduce the chances that she dies of a leading cause of death among elderly women?

The effects of this new breast cancer cost-consciousness are likely to be large. Medicare generally adopts the panel's recommendations when it makes coverage decisions for seniors, and its judgments also play a large role in the private insurance markets. Yes, people could pay for mammography out of pocket. This is fine with us, but it is also emphatically not the world of first-dollar insurance coverage we live in, in which reimbursement decisions deeply influence the practice of medicine.

More important for the future, every Democratic version of ObamaCare makes this task force an arbiter of the benefits that private insurers will be required to cover as they are converted into government contractors. What are now merely recommendations will become de facto rules, and under national health care these kinds of cost analyses will inevitably become more common as government decides where finite tax dollars are allowed to go.

In a rational system, the responsibility for health care ought to reside with patients and their doctors. James Thrall, a Harvard medical professor and chairman of the American College of Radiology, tells us that the breast cancer decision shows the dangers of medicine being reduced to "accounting exercises subject to interpretations and underlying assumptions," and based on costs and large group averages, not individuals.

"I fear that we are entering an era of deliberate decisions where we choose to trade people's lives for money," Dr. Thrall continued. He's not overstating the case, as the 12% of women who will develop breast cancer during their lifetimes may now better appreciate.

More spending on "prevention" has long been the cry of health reformers, and President Obama has been especially forceful. In his health speech to Congress in September, the President made a point of emphasizing "routine checkups and preventative care, like mammograms and colonoscopies—because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse."

It turns out that there is, in fact, a reason: Screening for breast cancer will cost the government too much money, even if it saves lives.

Mayor Praises Quality of life and Dental HealthCare in Yellow Springs

Yellow Springs will be featured in the magazine’s November issue, along with Granville, Sylvania, Willoughby and Cambridge.

To determine the honorees, Ohio Magazine solicited nominations and conducted site visits across the state. The editors evaluated the nominees in six categories, including community spirit, education, entertainment, health and safety, business environment and culture and heritage. Yellow Springs was the winner for the southwest region of Ohio.

In celebration of the designation, Yellow Springs will play host to the Best Hometown Celebration on Friday. Festivities will kick off at 5:30 p.m. at Senior Center Plaza at 227 Xenia Ave. with a local dance troupe performing its “Mellow Yellow Dance,” created especially for the celebration.

Other activities will include songs from the 2003 production: “The Peculiarly Salubrious, Singular and Curious, Mildly Outrageous and Sometimes Lugubrious History of a Natural Spring and the Town That Grew Up Around It,” and responses to the question “Why is Yellow Springs the Best Hometown” will be read by local children followed by words from local officials and the award presentation

from Dayton Business Journal

Shyam Subramanian, MD, FCCP, from Baylor College of Medicine in Houston, TX notes the connection between the two disorders, saying "The relationship between obstructive sleep apnea and sleep bruxism is usually related to an arousal response. The ending of an apneic event may be accompanied by a number of mouth phenomena, such as snoring, gasps, mumbles, and teeth grinding," adding "Men typically have more severe sleep apnea, and perhaps may have more arousal responses, which may explain the higher prevalence of teeth grinding in men. Besides, men characteristically tend to report more symptoms of sleep apnea than women, such as snoring, loud grunting, and witnessed apneas."

The link between sleep apnea and bruxism is related to many factors, such as high levels of anxiety and the use of caffeine. According to Dr. Subramanian "High levels of anxiety can lead to bruxism, and untreated sleep apnea is known to cause mood disturbances including depression and anxiety," adding "Daytime sleepiness from sleep apnea may cause a person to ingest caffeine, and this has also been associated with a high risk of bruxism."

Your best defense against both sleep apnea and bruxism is communicating with both your dentist and your doctor. Diagnosing sleep apnea involves participating in a sleep study. Diagnosing bruxism involves a complete examination from your dentist that looks at the wear patterns on your teeth by obtaining dental impressions that are used to fabricate diagnostic study models, and radiographs such as a cephalometric and/or panorex for the dentist to study.

If the symptoms of sleep apnea or the symptoms of bruxism sound familiar to you; contact both your dentist and your doctor. Early diagnosis is always highly regarded as being a part of a successful treatment plan.

Sleep Apnea Connected to Bruxism, Says Study originally appeared on About.com Dental Care on Tuesday, November 17th, 2009 at 00:20:51.

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Patients with developing cavities and/or insufficient saliva.can use MI Paste to reverse the cavity process.

This is called Re-mineralization.
MI Paste can rebuild the lost minerals in your teeth.

Prospec MI Paste is smushed onto your teeth with your finger and just allowed to remain for three to five minutes.

It has the consistency of thin toothpaste. WE can dispense this to you for home use 

The paste may be brushed on with a toothbrush or applied in full arch trays. There is no need to rinse afterward, and it is safe to swallow. Specific site application to individual incipient caries lesions with the finger is also possible. The product is safe for those lactose-intolerant.

This is the latest in effective self-care for stopping tooth decay.

It wasn't an implosion, but last week Yellow Springs witnessed the disappearance of a healthcare facility: The Wright State Medical School Clinic that had served so many for so long.

Wright State University Yellow Springs Ohio Health Care Clinic was Razed last week. Yellow Springs Dental Care and The Friends Care Center mourn the loss of our neighbor in providing quality care for Yellow Springs and environs. Healthcare Reform, Healthcare access. As our national debate on healthcare continues, there can be no doubt that healthcare will be less available in Yellow Springs because of this tragedy. We are all a little bit poorer for the loss of this Yellow Springs health facility.

Quality of Yellow Springs Healthcare from John Russell on Vimeo.

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1. 75% wanted fillings for cavities
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4. 40% wanted implants
5. 25% wanted cosmetic treatment
   

Patients with an acute respiratory illness should be identified at check-in and placed in a single-patient room with the door kept closed.
• Staff should offer a disposable surgical mask to persons who are coughing, or provide tissues and no-touch receptacles for used tissue disposal. The ill person should wear a surgical mask when outside the patient room.
• Dental healthcare personnel assessing a patient with influenza-like illness should wear disposable surgical facemask, non-sterile gloves, gown, and eye protection (e.g., goggles) to prevent direct skin and conjunctival exposure.
• Patient and dental healthcare workers should perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials.

Routine cleaning and disinfection strategies used during influenza seasons can be applied to the environmental management of swine influenza.
• Staff experiencing influenza-like-illness (ILI) (fever with either cough or sore throat, muscle aches) should not report to work.

• Staff who experience ILI and wish to seek medical care should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician's office, or hospital.

• Staff who were not using appropriate personal protective equipment during close contact with a confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case's infectious period should receive chemoprophylaxis according to CDC guidance (http://www.cdc.gov/swineflu/recommendations.htm).

• Staff who have difficulty breathing or shortness of breath, or are believed to be severely ill, should seek immediate medical attention.

We are all advised to stay home if the signs of influenza-like-illness are present. If you have an appointment, contact your office for instruction. Chances are, the dentist will recommend the appointment is rescheduled until the ILI symptoms are gone. If you require emergency dental treatment, the following guidelines have been established:

"If urgent dental care is required and swine influenza A (H1N1) has either been confirmed or is suspected, the care should be provided in a facility (e.g., hospital with dental care capabilities) that provides airborne infection isolation (i.e., airborne infection isolation room with negative pressure air handling with 6 to 12 air changes per hour).

For aerosol-generating procedures, use a procedure room with negative pressure air handling. Personnel providing direct patient care for suspected or confirmed swine influenza A (H1N1) cases should wear a fit-tested disposable N95 respirator when entering the patient room and when performing dental procedures. Respirator use should be in the context of a complete respiratory protection program in accordance with Occupational Safety and Health Administration (OSHA) regulations.

Talk to your dentist if you have any concerns or questions about visiting the dental office during flu season.
_{Source:
Centers for Disease Control and Prevention.}

H1N1 (Swine Flu) Information for Dental Offices and Dental Patients originally appeared on About.com Dental Care on Monday, November 9th, 2009 at 19:32:22.

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School-based dental programs provide children with essential dental care, including dental sealants. The Centers for Disease Control and Prevention (CDC) will provide approximately $22 million in funding over the next five years, to 16 states. This funding is used to help these states improve their school-based dental programs to provide the best care possible for children from low income families.

Are you interested to know what your state's oral health plan is? Take a look at this state-by state chart, to see what steps are being taken to improve oral health where you reside.

School-Based Dental Programs originally appeared on About.com Dental Care on Tuesday, November 3rd, 2009 at 03:18:45.

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I was introduced to the Smiles Change Lives program earlier this year, and could not wait to share their information with you. Have a look at my profile on the Smiles Change Lives program, and when you're done, I'm sure you will know exactly what to do with all of your extra/leftover candy!

Are You Looking for a Place to Unload Your Excess Halloween Candy This Year? originally appeared on About.com Dental Care on Monday, October 26th, 2009 at 18:09:18.

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1. Imaging of the Paranasal Sinuses, the Diagnosis of Sinusitis, and the Role of 3-D CT Guided Sinus Surgery in Treating Chronic Sinusitis I wrote a research paper over a year...
2. Stronger Cavity Fillings Made from Human A new dental filling material uses parts from...
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"What factors should you consider when looking for a dentist? Cost is definitely an important factor, but it shouldn't be the only one. What type of dental services do you require? Do you have dental insurance? These are just a couple of the type of questions you should ask yourself. Another important inquiry to make in your search for a dentist is the type of technology that is used.

Is technology in the dental industry really important in your search for a dentist? It is if you like the idea of dental procedures taking less time, spending less money for dental procedures, and experiencing less discomfort while sitting in a dentist's chair. The dental industry has experienced significant technological advancements that can greatly benefit both you and your dentist. Of course, a dental office with every possible gadget and instrument on the market is not necessarily the best choice. A dental office with current technology that enhances your experience without resulting in an astronomical increase in fees has the best interest of their patients in mind.

The technology you want a dentist to have depends greatly on what services you require. The following are a few of the current dental technologies from which most dental patients can benefit:

• Digital radiography that streamlines administrative and dental processes
• Digital x-rays that significantly lessen radiation exposure. Especially in case of panoramic x-rays, digital technology is important since ordinary panoramic x-rays expose your jaw and head to higher levels of radiation.
• Dental lasers that reduce patient discomfort
• Intra-oral cameras that enable better visual diagnostics
• Air abrasion that reduces patient anxiety with sounds associated with drills
• Digital Imaging Fiber-Optic Trans-Illumination that enables the dentist to diagnose conditions more accurately

If you require specialized dental services, such as cosmetic dentistry, you should research the current technology associated with these services and ensure that the dentist you choose has these tools available and is very knowledgeable and experienced in their use.

Using technology as one of the deciding factors for selecting a dentist can lead you down a path of exploration that may make you feel uncomfortable. There are many resources available to help you learn and understand the various technologies that are used in dentistry. The American Dental Association website (www.ada.org) is a good place to start. You can simply search their website for technologies used in the dental industry and learn what the standard is currently and what technologies are more in the experimental stage. It will take you a bit more effort to research this information, but your results will help you more closely identify the dentist that is best for you.

Resources

Journal of American Dental Association, Vol 136, No 10, 1358-1360 "Dental digital radiography"

Journal of American Dental Association, Vol 135, No suppl_1, 18S-22S "How technology can help improve office efficiency"

Journal of American of Dental Association, Vol 135, No suppl_1, 11S-16S "Can technology help dentists deliver better patient care?"

Part Four: Including Technology in Your Search for the Perfect Dentist originally appeared on About.com Dental Care on Monday, October 19th, 2009 at 13:11:39.

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1. Oral Cancer Diagnosed Too Late Across the world, more than 500,000 new cases...
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