Caregivers Are Key In Protecting Kids' Dental Health

NEW YORK (Reuters Health) - Many kids on Medicaid are not receiving dental care, and those who do often first show up with a dental emergency, according to a new study.

Less than half of a group of four-year-olds the researchers followed had ever visited a dentist, and caregivers who neglected their own oral health tended to neglect that of their children too.

"We know that both good oral health and dental problems tend to cluster and co-occur in families," said Kimon Divaris, who led the study at the UNC School of Dentistry at the University of North Carolina at Chapel Hill.

According to the American Academy of Pediatric Dentistry, children should visit a dentist for their first check-up when their first tooth appears, or no later than their first birthday. The AAPD recommends check-ups every six months after that to prevent cavities and other problems.

Oral health is part of general health, and dental problems in young children have been linked to other negative consequences including discomfort and pain, reduced quality of life, failure to thrive, time lost both from school and parents' work and financial expenditures for families and the health system, Divaris told Reuters Health in an email.

Although doctors and dentists have worked to make dental care more accessible for all kids, parents and caregivers play an important role in when and whether kids on Medicaid see a dentist, the authors write in the journal Pediatrics.

"What we are still trying to figure out are the mechanisms that underlie these associations: are they social, economic, cultural, behavioral, genetic or a combination?" Divaris said.

The researchers accessed Medicaid data and caregiver interviews for 1,000 children with no previous dental visits in 2007 and used records to follow the children for two years. On average, kids entering the study were 16 months old.

Over the course of the study, 39 percent of the children saw a dentist for the first time. For more than one in seven of these, that first visit was for a dental emergency.

Kids who had oral health problems as 16-month-olds were more likely to visit a dentist, and were more likely to require emergency care during the study period.

But the analysis did not consider oral health screenings or preventive services provided by pediatricians, which certainly would qualify as improving oral health, said Justin Blackburn of the Department of Health Care Organization and Policy at the University of Alabama at Birmingham School of Public Health.

"We still need more research to understand the benefits of 'early entry into the dental care system' as well as barriers to the receipt of oral care," Blackburn told Reuters Health in an email.

The overwhelming majority of caregivers in this study were female, single and low-income. Kids whose caregivers neglected their own dental health were less likely to see a dentist, the authors wrote.

"Early, preventive visits are aligned with the establishment of a 'dental home'," said Divaris, where there's "an ongoing relationship between the dentist and the patient, and comprehensive oral healthcare is delivered in a continuously accessible, coordinated and family-centered manner."

Regular visits also help educate parents about oral hygiene, diet, cavity risk and preventive measures like fluoride varnishes, he said.

Because babies' teeth fall out, parents generally don't realize they're important, according to Jane A. Weintraub, dean of the UNC School of Dentistry.

Children develop tooth decay, toothache and infections, much of which is preventable with good dental care, she told Reuters Health in an email.

According to a 2010 U.S. study, 14 percent of three- to five-year-olds had untreated dental decay, including 25 percent of kids living below the poverty level.

Although the new study, and others before it, have found that individual characteristics of caregivers, like how much they care for their own teeth, predict whether or not the child will visit a dentist, there may be larger social forces at work, Divaris said.

There may not be enough dental providers in some communities, or little community support, or there may be an attitude of "dental fatalism," in which people assume getting cavities as a child is the norm and is accepted, he said.

These barriers can't easily be addressed, he added, but there are ways to reduce them.

Virtually all children will go to a pediatrician for check-ups and vaccinations, and pediatricians in that setting could perform oral health screenings, educate parents and refer them to dentists, he said.

In some places, school-based programs deliver oral health services without requiring parental involvement, he said.

"Actually, community water fluoridation is a great public health success story along these lines, where a proven measure is delivered in large population segments without relying on individuals' actions," he said.

He urged parents and caregivers not to wait for a problem to develop before taking their children to the dentist.

SOURCE: 
http://bit.ly/1npMiDN Pediatrics
http://news.yahoo.com/caregivers-key-protecting-kids-dental-health-222419880.html / Yahoo News!

The Intersection of Cutting-Edge Technology and Your Dental Health

Image by PhillyMag

Take a look around almost any public space today, and you’ll find that technology is everywhere: from smartphones to smartwatches, tablet computers to e-readers, the latest devices are—literally—in the hands of most people. The same can be said for medical professionals. In the field of dentistry, digital X-rays are on the rise and offer a host of benefits.


When your dentist takes X-rays digitally, small comfortable sensors are placed in the mouth. The sensors connect to a computer and send imaging information to a digital-image capturing device, such as a TK. Within moments, the images are visible on the computer screen, and the image quality can be much more detailed, with less “visual noise” (or imperfections), than traditional radiography.

Similar to digital cameras versus shooting on film, the images are accessible immediately, because you don’t need to wait for traditional film to develop before the images are visible. Another similarity to digital photography: the X-rays can be enlarged as necessary for your dentist to carefully examine problem areas, meaning cavities, areas of decay, and other potential problems can be identified more easily. Digital radiography exposes patients 10 to 20 percent less radiation than traditional imaging methods, which is reassuring to many patients. Furthermore, the digital X-rays can be shared quickly and easily with other practitioners, such as in the case of getting a second opinion, switching dentists upon moving, or seeing a dental specialist for specific conditions.

Another advantage over traditional X-rays is what’s known as digital subtraction radiography. With special computer software, your dentist can easily compare new X-rays to older ones and precisely observe the differences between the two. By “subtracting” the similar areas of the images, subtraction radiography emphasizes just the areas where change has occurred, which can allow your dentist to identify the progression of a condition better than is possible with traditional X-rays.


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What The Health Of Your Teeth And Gums Has To Do With The Health Of Your Heart

A new study provides further evidence of the link between oral health and heart health.

Researchers found an association between periodontal disease, including gum bleeding and tooth loss, and heart risk factors, including large waist circumference and high blood pressure and cholesterol levels.

"The evident and consistent relationship between self-reported dental status and CV risk in this population could point towards periodontal disease being a risk factor for incident CHD," study researcher Dr. Ola Vedin, of the University of Uppsala, said in a statement.

The study, published in the European Journal of Preventive Cardiology, included 15,828 people from 39 countries who were part of the STABILITY trial. All the participants had coronary heart disease and at least another heart risk factor; researchers had them complete questionnaires regarding their lifestyles, including dental health habits, as well as how many teeth they had remaining and how often they experienced gum bleeding. The participants also underwent blood testing and a physical exam. Nearly 70 percent of the participants were current or former smokers.

One-fourth of the participants reported gum bleeding during teeth-brushing; 41 percent reported having fewer than 15 teeth left, and 16 percent had no teeth at all.

Researchers found an association not only between number of heart risk factors and periodontal disease, but also higher levels of these heart disease biomarkers and periodontal disease.

"It is still a matter of debate whether periodontal disease is an independent risk factor for coronary heart disease. Some studies point to a moderate association while others are contradictory. Our findings show an association between self-reported periodontal disease and several cardiovascular risk factors and as such lend support to a possible association between the conditions," Vedin said in the statement. However, more research is needed before one could definitively say that dental hygiene is a way to lower heart risks, Vedin added.

Still, other studies have linked oral health with heart health. A study presented in 2011 at a meeting of the American Heart Association, for instance, showed that getting your teeth professionally cleaned even just once in your life is associated with a decreased risk of heart attack and stroke (though the association is strongest among people who get yearly cleanings).

And another study published last year in the journal General Dentistry showed an association between gum disease and obesity, though that research did not say which one caused the other.

Poor oral health has also been linked in other research to pancreatic cancer, as well as oral human papillomavirus. 


Source:
Huffington Post

Dental Health & Kids: A Guide for Every Age

Oral hygiene and healthy teeth are important at any age, even infancy. Healthy baby teeth guide permanent teeth into place correctly, help properly shape babies’ faces, and help kids chew and eat properly and speak clearly. Unhealthy teeth can affect kids’ and babies’ overall health, causing them pain and to have difficulty eating, which can lead to problems in kids’ general development. Tooth decay in baby teeth is the most chronic disease of early childhood. It can lead to damage in permanent teeth, resulting in painful and costly treatments.

This guide will help you learn about keeping your kids’ teeth healthy and strong from infancy on and set them up for a lifetime of healthy teeth and good dental hygiene practices.

Teething
Good oral hygiene for babies begins even before teething starts. As soon as he’s born, parents should wipe their baby’s gums with a soft, damp cloth after feeding. This helps prevent bacteria from building up.

Between 6 and 8 months, your baby should start teething — though some children do not begin teething until later. Teething is often uncomfortable for babies, but there are several things you can do to ease their discomfort, including:

Letting them chew on a cool object like a firm rubber teething ring or cold apple (avoid breakable objects and liquid-filled teething rings)
Rub their gums with a cool, wet washcloth
Feed them soft, cool food like applesauce and yogurt
In cases of extreme irritability or discomfort, give them acetaminophen or ibuprofen
Teething gels may help, but don’t use too much.
Do not cut the gums or place alcohol or anything frozen against them. Do not give your baby aspirin or place it against the gums. Avoid teething powders.

Teething can last for a year or more. Babies should have all their teeth in by 30 months.

Tooth brushing for kids
Once your baby’s teeth begin to come in, it’s time to start cleaning them. Use a small, soft toothbrush or a clean, soft cloth. Many dentists recommend cleaning kids’ teeth only with water until they are 2 years old; at that age, switch to a pea-sized amount of fluoride toothpaste.

Brush your child’s teeth twice a day for two minutes and pay special attention to the back molars, where cavities tend to develop. Kids will need help brushing until about age 8. To ensure your child learns to brush properly, guide his hand during brushing so that he will experience the correct movement.

Begin flossing your child’s teeth as soon as two teeth that touch appear.

First trip to the dentist
The American Academy of Pediatric Dentistry recommends that all children visit the dentist as soon as their first tooth comes in, or by the age of 1. After that, kids should see the dentist every six months, as should adults. Take your child to a pediatric dentist who will explain what is happening to your child, show him the tools, let him sit on your lap during procedures if he is nervous, and provide prizes at the end of the visit.

The first trip to the dentist is called a “well-baby” visit. The dentist will look for early problems in your child’s teeth and discuss important information about dental hygiene for kids, diet, bottle use and thumb sucking habits.

Baby teeth
Also called primary teeth, milk teeth, and deciduous teeth, baby teeth are important to a child’s healthy development. Not only do they help kids chew and speak properly, but also they hold space in the jaw for permanent teeth to develop and eventually grow in.

Cavities in baby teeth are among the most common children’s health disorders. In addition to brushing, flossing and trips to the dentist, parents should avoid giving kids too much sugar or starch, which can cause tooth decay.

During naptime or at bedtime, give your baby a bottle filled with only water, as filling the bottle with juice, formula or even breast milk and letting your baby suck on it during sleep can cause tooth decay. The same goes for sippy cups: if your child likes to carry around a sippy cup, keep it filled with water. Try to have your child switch from sippy to open cups around his first birthday.

Usually, children can safely suck their thumbs, pacifiers, or fingers until about age 4 with no tooth decay problems. After age 4, tell the dentist if your child still has a sucking habit.

Teeth grinding in children
Medically termed bruxism, teeth grinding and jaw clenching is a common problem for children, affecting at least 20 percent of kids. It usually occurs during sleep or when a child is under stress. Episodes last for about four seconds and happen approximately six times per hour during the night.

Kids may grind their teeth for different reasons, including improper alignment of jaws, as a response to pain such as teething, and stress. Studies have shown that kids with ADHD, behavioral problems, cerebral palsy, and those taking certain medications are more likely to grind their teeth or clench their jaws.

If your child grinds or clenches his teeth, you should take him to the dentist. Grinding teeth often has no adverse effects and most kids grow out of it by adolescence. Nevertheless, it can cause problems and should be treated. Minor problems are:

• Headaches
• Earaches
• Painful chewing
• Sore face or jaw
• Grinding sound annoying other family members

More serious consequences include:

• Worn down tooth enamel
• Chipped teeth
• Increased temperature sensitivity
• Facial pain and jaw problems, such as TMJ (temporomandibular joint disease)
• To help stop your child from grinding or clenching teeth, the dentist may suggest a mouth guard specially molded to your child’s mouth. If teeth grinding is the result of stress, try talking with your child about his feelings regularly and doing soothing activities before bed.

Common questions about losing baby teeth
How many teeth do children have?

Kids have 20 baby teeth. Adults grow 32 teeth, so eventually your child will grow 32 teeth. This usually happens by the teenage years, though everyone has a different timeline. Sometimes adults have their wisdom teeth removed. If they are all removed, adults have 28 teeth.

When do kids lose their teeth?

Kids typically start losing baby teeth around age 6. Girls often start to lose baby teeth before boys. Most kids will have lost all their baby teeth by age 13.

Baby teeth usually fall out in the order that they first appeared: two bottom front teeth, two top front teeth, lateral incisors, first/front molars, canines and second/back molars.

How many teeth do kids lose?

Kids will lose 20 teeth — all of their baby teeth — over the course of about seven years.


Source:
LiveScience.com

Keeping a dog’s teeth healthy can increase life expectancy

Did you know that oral hygiene is tied to your pet’s overall health? Studies show that keeping a pet’s mouth healthy may increase life expectancy as much as two years.

Owners can prevent or reduce their dog’s chances of developing oral disease by beginning a hygiene regimen at an early age.

“It’s important to start good oral hygiene as early as possible,” recommended Bob Scharf, president of Sergeant’s Pet Care Products. “According to the American Veterinary Dental Society, 80 percent of dogs show symptoms of oral disease by the age of 3. However, it’s never too late to take better care of your dog’s teeth.”

Signs of oral disease

Keep an eye out for bad breath and unusual or excessive drooling or pawing at the mouth, as they can be signs of dental problems.

In addition to bad breath, poor oral health can lead to kidney and heart disease. The bacteria in the mouth can build up, entering the bloodstream via the gums. This puts extra work on the kidneys to filter out bacteria. And these bacteria can set up house in a dog’s heart valves, potentially leading to a condition called valvular endocarditis.

Establish a routine

To ensure better dental health, brush your dog’s teeth daily. This can be daunting, but half the challenge is getting started and developing a routine.

Look for canine dental products that target plaque – a buildup of bacteria – and tartar, which occurs when plaque hardens and adheres to tooth enamel.

Get dogs used to the experience by squeezing canine toothpaste on your finger and putting it between their cheeks and gums. Canine toothpaste has special food flavoring, making it appealing to pets. As they lick the paste, praise them constantly.

Keep initial brushing sessions to a few gentle seconds. Once the dog is used to having its teeth brushed, increase the time to about a minute every day.

Treats can help

Treats and other items can help with canine oral care, such as dental chews and rawhide, which promote chewing and mechanically remove plaque. Products such as Sentry Petrodex Filled Dental Bones, available at retailers including PetSmart and Petco can help prevent plaque while keeping teeth clean and breath fresh. In addition, paste inside the bone has a residual component that adheres to dogs’ teeth and helps whiten by cleaning away plaque and tartar, according to the manufacturer.

Additionally, feeding dogs hard kibbles instead of soft, moist food is slightly better at keeping plaque from accumulating.


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Oral health can reduce risk of many ailments

DEARBORN — Everything from heart attacks and strokes to Alzheimer’s, infertility and diabetes can be prevented or at least reduced with better oral health, according to a presentation Thursday night at The Dearborn Inn.

The evening included a screening of the hour-long documentary “Say Ahh.” Trailers for the film say it is about “fighting the world’s largest cavity — the one in our health care system.”

The film touts “complete health dentistry” where dentists look beyond their patient’s mouth and gums. Doctors, in turn, need to be more direct with their patients about the risks from poor oral health, the film says, suggesting both providers should work more closely together. Such a proactive approach to health care could stop the decline in American’s health and save billions of dollars in costs, according to “Say Ahh.”

The evening was sponsored by Contemporary Dentistry, which has offices in Canton and in Dearborn at 5211 Schaefer Road. Drs. Nader Bazzi, Rima Bazzi and Julie Atoui all graduated from the University of Detroit-Mercy Dental School. The two practices tout themselves as being “focused on complete dental health.”

The three dentists stress the connection between oral and overall health, Nader Bazzi said.

“I’m a dentist that is really passionate about my field,” he said.

Michigan ranks 34th in the country for overall health, and many of the state’s risk factors such as diabetes, are impacted by oral health, Bazzi told the crowd of more than 70 people.

He sympathized with the doctors he had invited saying he knows most are overworked, pressed for time, and see their profit margins shrinking with health care reforms. However, focusing on oral health is a key to reducing health care costs and improving patients’ overall health and quality of life, he said.

“We have the ability to really affect change,” Bazzi said.

Dr. Chip Whitney, a family care doctor from Pennsylvania, also spoke. Whitney appears in “Say Ahh” arguing for the importance of looking at oral health.

He has had several cases of patients with diseases, especially heart disease and stroke, who cannot seem to improve their health until they get oral issues addressed.

Often, after patients started regular dentist visits to address periodontal disease, all of their other health statistics “spun in the right directions,” he said.

He showed a book that he said contained more than 1,000 studies, some very comprehensive, that showed a strong link between oral health and overall or systemic health.

“If there’s a little blood in the sink, you’ve got a problem,” he said.

In the movie, Whitney says that he feels medicine is entering its third age. The first focused on trying to combat infections, which was followed in more modern times by huge advances in treating illnesses, including vaccines. In the new age, the focus needs to be on preventing illnesses, and that has to include oral health.

Blood pressure, diabetes, heart disease and more are linked to bacteria in the mouth getting in the patient’s blood, Whitney said.

“Once I looked into the mouth, I found a lot of problems that I might not have found a source for otherwise,” he said.

Germs in the mouth can enter the blood. This is especially true if people are seeing blood after brushing because it means there is an open path for bacteria to enter the blood stream. But even seemingly smaller oral issues can be cause for concern, for example a sore tooth could be hiding an infection.

Such infections can spread to the blood, which leads to inflammation, the movie said. That hidden inflammation is linked to heart disease, strokes, some types of cancer and diabetes, according to the movie.

One study suggested that up to 50 percent of all acute heart attacks are linked to oral bacteria getting in the blood. Heart attacks are the number one killer in America, and strokes are the top cause for disability.

One doctor used diabetes as another example. Inflammation from oral bacteria causes insulin resistance, much the same way having too much fat does, the movie says.

Whitney and others in the movie stress oral problems are not just related to diseases like diabetes, but research increasingly indicates oral bacteria may actually cause the other health concerns.

For example, one study on the brains of Alzheimer’s patients showed that 90 percent had a specific oral bacteria, compared to only 13 percent of patients without Alzheimer’s, Whitney said.

For heart disease, he said other things may contribute to problems in arteries such as cholesterol, and compared that to packing your body with gasoline. Peridontal disease is the match, Whitney said.



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Decay-busting toothpaste for children in Scotland

Tooth decay is falling but the vulnerable are still at risk. Picture: PA

Children in Scotland at increased risk of dental decay should be offered special high-fluoride toothpaste on prescription to help protect their teeth, new guidance says.

According to recommendations by the Scottish Intercollegiate Guidelines Network (SIGN), youngsters with a higher chance of developing tooth decay, such as those from deprived backgrounds, should use products with higher concentrations of fluoride.

Such toothpastes can only be issued to parents on prescription, with toothpastes with lower levels of fluoride available in shops.

SIGN, part of Healthcare Improvement Scotland (HIS), also sets out further advice to boost child dental health, including twice-yearly fluoride varnishing by dentists.

Tooth decay is caused by a build-up of plaque and other bacteria, but dental health among children in Scotland has improved in the last 30 years.

In 1988 only 42 per cent of Primary 1 children had no obvious dental decay, but by last year this had increased to 73 per cent.

But large numbers of children still suffer poor dental health, particularly those from more disadvantaged backgrounds. The most recent figures show that 82 per cent of children in the least deprived group had no signs of decay, falling to 61 per cent in those from the most deprived backgrounds.

The new guidance says that most children up to the age of 18 should use toothpastes ranging from 1,000 to 1,500 parts per million fluoride (ppmF).

But it said that following risk assessment, children up to the age of ten years who are at increased risk of tooth decay, due to factors such as deprivation and poor diet, should be advised to use toothpastes at 1,500 ppmF.

And those aged 10 to 16 years who are at increased risk should use toothpastes at a concentration of 2,800 ppmF.

Toothpastes from around 700 to 1,500 ppmF are available in shops, while products above 2,800 ppmF are only available on prescription.

The guidance says that parents play the greatest role in preventing tooth decay and there is no evidence to show that powered, electric toothbrushes were more effective than manual toothbrushes.

Derek Richards, chair of the group which developed the guidance and director of the Centre for Evidence-based Dentistry at Dundee University, said: “The recommendations recognise that dental care is not as straightforward as most people would expect and should be managed on an individual basis, by the professionals.

“But there is also a bigger part for parents to play as they should be aware of useful tips such as checking the level of fluoride in toothpaste and monitor the amount they put on the brush for young children.”

Dr Nigel Carter, chief executive of the British Dental Health Foundation, said: “High fluoride toothpaste is an effective way of preventing tooth decay, and fluoride varnish treatments are already available for children from the age of three.

“It is for those children who have had their oral health overlooked that high fluoride toothpaste on prescription becomes necessary, particularly in deprived areas of the country."


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Experts warn using mouthwash more than twice a day can give you cancer

                                 

A health alert linking the over-use of mouthwash with cancer was issued by medical experts last night.

The “elevated risk” emerged from Europe-wide research into the popular and high-selling breath-freshening product.

Study leader Dr David Conway, from the University of Glasgow, warned: “We have found that using mouthwash excessively – three or more times a day – raises the risk of cancer .

“I know that some people who regularly smoke or drink alcohol use mouthwash to hide the smell.

"I would advise against any excessive use of it.”

He went on: “There are some occasions and conditions for which a dentist could prescribe a mouthwash.

“It could be that a patient has a low salivary flow because of a particular condition or medicine they are taking.

“But unless a dentist has prescribed a mouthwash, personally I think all you need for good oral health is regular brushing with a fluoride toothpaste and flossing, plus regular check-ups by a dentist.”

Dr Conway added: “We did not find any significant increase in risk associated with using mouthwash once or twice a day.”

Smoking and alcohol consumption are established risk factors in oral cancer, which is diagnosed in 5,000 people across the UK each year and causes 1,600 deaths.

The alcohol in mouthwash is thought to help cancer-causing substances such as nicotine permeate the mouth lining.

It can also produce a substance called acetaldehyde, a carcinogen, which can accumulate when swished around the mouth.

The study is published today in the respected specialist journal Oral Oncology.

It looked at the cases of 1,962 patients with mouth or throat cancer and at 1,993 people without the disease and was conducted by 13 universities, including Glasgow, across nine countries.

The researchers also found evidence that people with poor dental care – those who never or hardly ever brushed their teeth – also faced an increased risk of developing cancer.

Prof Wolfgang Ahrens, of the Bremen Institute for Prevention Research and Social Medicine in Germany, said: “These results are really important.

“Up until now it was not really known if these dental risk factors were independent of the well-known risks for mouth and throat cancers – smoking, alcohol and low socio-economic status.”

A study published in the Australian Dental Journal in 2009 found that the use of mouthwash increased the odds of oral cancer by nine times in current smokers.

The researchers said that on the basis of their review they “believe that there is now sufficient evidence to accept the proposition that alcohol-containing mouthwashes contribute to the increased risk of development of oral cancer”.

They also said healthcare professionals should not recommend the long-term use of alcohol-based mouthwashes.

Figures released last June showed that 55% of Britons use a mouthwash.

Source: 

Mirror.co.uk

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4 Coding Tips to Stop Leaving Money on the Table`

As the dental benefits landscape continues to shift to PPOs and reimbursement rates continue to shrink, many offices are struggling with increasing overhead and decreasing cash flow and profit margins. Coding correctly is critical for maximizing reimbursement, increasing cash flow, and minimizing any coding errors that could result in fines or worse.

Every month we see dentists leave thousands of dollars on the table simply due to coding errors. Given the ever-changing world of coding, mistakes are inevitable. According to Dr. Charles Blair, there have been 135 coding changes, revisions, or deletions in just the past two years. To minimize your errors and maximize reimbursement, a thorough coding review should be conducted each year.

The following are four codes to help you get started in 2014.

1. Fluoride Codes D1208 and D1206 

Fluoride codes D1203 and D1204 for child and adult fluoride treatments were discontinued in 2013. They were replaced with code D1208, which is used for child and adult applications. We still see many offices reporting the old codes and most likely not being reimbursed for the procedures.
There were also changes to the fluoride varnish code D1206 last year. Previous restrictions to patients with moderate to high caries risk have been eliminated. D1206 is applicable for child and adult reporting and pays a higher UCR than D1208.

2. D0140 Limited Oral Evaluation – Problem Focused or D9110 Palliative (Emergency) Treatment of Dental Pain
D9110 is an underutilized code; overwhelmingly offices code D0140 for emergency visits when treating a patient for pain or discomfort. D0140 is an evaluation code and limited to the "one evaluation per six months" or "two evaluations per year" rule. Consider reporting D9110 for minor nondefinitive procedures to reduce discomfort, sensitivity, or pain at an emergency visit. D9110 is a procedure code and will not use one of the exam limitations. This palliative code pays a higher UCR than D0140. When reporting D9110, include the required narrative. Palliative D9110 should not be used in conjunction with a definitive procedure.

3. D0180 Comprehensive Periodontal Evaluation – New or Established Patient
This evaluation code may be reported for established periodontal patients, patients showing signs or symptoms of periodontal disease, and for patients with risk factors such as smoking and diabetes. D0180 requires a complete and detailed periodontal evaluation, including full-mouth probing and detailed charting. D0180 may be reported at the same visit as a D4910; however, it may be downgraded to a D0120 fee. Do not report D0180 in addition to a D0150 comprehensive evaluation. D0180 usually pays a slightly higher UCR than D0150.

4. D1352 Preventative Resin Restoration in a Moderate to High Caries Risk Patient – Permanent Tooth
D1352 is a conservative restoration of an active cavitated lesion in a pit or fissure that does not extend into dentin, and includes placement of a sealant in any radiating noncarious fissures or pits. Do not report this preventive type resin restoration if the prep and decay extend into dentin. See D2391 for one-surface composite. Do not report this preventative restoration if there is no active decay in the enamel. See D1351 for sealant. Do not report D1352 for a primary tooth. According to Dr. Charles Blair, some plans will pay more than two times the fee for a sealant but less than a one-surface composite, and some plans will pay the alternate sealant benefit.'

The average dental office can increase production tens of thousands of dollars a year simply by using these and other codes properly. We recommend combining a Henry Schein Practice analysis along with Dr. Charles Blair's Practice Booster to maximize coding efficiencies, cash flow, and reduce costly errors.


Written by: 
Jim Philhower
DENTISTRY IQ

Dental anxiety? Evergreen Family Dental offers some tips

Not keen on visiting the dentist? There is a name for that. Odontophobia or dentophobia is the technical term for 'fear of the dentist'. According to WebMd, between 9% and 20% of Americans avoid going to the dentist because of anxiety or fear; however routine dental check ups are essential to good health.

Ridgefield dentist, Dr. Sandhu, owner of Evergreen Family Dental, explains, "The comfort, relaxation and happiness of the patient are embedded deep at the heart of any good dental practice."

Dr. Sandhu  shares some tips to help alleviate your dental stress.

Talk to the dentist – The dentist is not a mind reader. Though it can be hard to talk about irrational fears with a stranger, the dentist can take extra precautions during visits if fears and anxiety are communicated.

Bring ear-buds or headphones and listen to your favorite songs – Music acts as a relaxant and also drowns out any fear-producing noises. Listening to calming music throughout the appointment will help to reduce anxiety.

Agree on a signal – Many people are afraid that the dentist will not know they are in significant pain during the appointment, and will carry on the procedure regardless. The best way to solve this problem is to agree on a "stop" hand signal with the dentist. Both parties can easily understand signals like raising the hand or tapping on the chair.

Spray the throat – Throat sprays (for example, Vicks® Chloraseptic® Throat Spray) can actually control the gag reflex. Two or three sprays will usually keep the reflex under control for about an hour.

Sedation – If there is no other way to cope, sedation offers an excellent option for many people. There are several types of sedation, but the general premise behind them is the same: the patient regains their faculties after treatment is complete.

Ask about alternatives – Advances in technology mean that dental microsurgery is now an option. Lasers can be used to prepare teeth for fillings, whiten teeth and remove staining. Discuss all the options with the dentist and decide on one that is effective and produces minimal anxiety.


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Smile, April is oral health month

Get ready to polish up those pearly whites as April is oral health month.



The Manitoba Dental Association (MDA) is using this month to bring awareness about the importance of maintaining healthy teeth and gums for overall general health.

“A lot of times when you see your dentist, your dentist isn’t just looking for cavities in your mouth, they’re also looking for other potential disorders you may have that can be shown through rapidly dividing cell tissue (oral mucosa) or other illnesses such as cancer,” said MDA president Dr. Michael Sullivan, who works at Portage Dental Associates.

The Canadian Dental Association (CDA) reports that poor oral health will not only affect a person’s ability to chew and digest food properly, but could also be a sign of something more serious. The CDA states there might be a relationship, or link, between oral disease and other health problems such as diabetes, certain kinds of pneumonia, heart disease, stroke, as well as premature and low birth-weight babies.

The CDA also reports that every year approximately 3,200 Canadians are diagnosed with oral cancer, of which 1,050 deaths will result. People over the age of 45 are most at risk.

In his 30-year career, Sullivan has seen his fair share of oral health problems, but he said the most prevalent oral issue most patients have is related to tissue damage.

“The number one issue is gingivitis, gum disease, you do see some people with cavities but more with gum issues,” he said.

Advances in oral technology, such as electric toothbrushes and better toothpastes, are helping people achieve proper gum health, according to Sullivan.

“There are some people who do an excellent job (at maintaining oral health) and others that don’t. It’s about creating awareness among that segment of the population – take care of your teeth,” he said.

The CDA reports that 48 per cent of Canadians, who don’t see a dentist at least once a year, acquire gum disease and that seven out of 10 will develop the illness at some time in their lives.

In the past 30 to 40 years, the way Canadians take care of their teeth has changed from a reactive approach to a more proactive approach, according to Dr. Scott Mather of Brightside Dental

“Before, patients would feel that since there was no pain there was no problem and when they finally had pain, they would go into the dentist. Usually at that point, when a patient has pain with a tooth, there are substantial amounts of work that need to be done and sometimes the tooth isn’t salvageable, whereas today the shift is much more of a proactive form,” he said.

In 2011, Canadians spent $13.7 billion for dental services, according to the CDA.

Both Mather and Sullivan recommend people visit their dentist at least once a year or every six months and to brush and floss regularly to maintain tooth and gum health.

Another shift in dental care is the rise in cosmetic procedures.

“I feel that patients are moving more towards wanting to look their best and wanting the Hollywood smile,” said Mather. “Which are great and fantastic things to do, but that will have to be built on a base of good oral health.”

To build on that base, the MDA and the provincial department of education have been teaching school children from kindergarten to Grade 6 about proper dental care.

“Each year, kids get their own oral health curriculum that brings awareness,” said Sullivan.

“Oral health used to be they zeroed in on one month out of the year, now it tends to be all year round with the delivery of programs and things of that nature.”


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