The sudden drop, the wind racing through your hair, the speeding around the curves and some loop the loops. You’re on a thrill ride of a lifetime! If you’re a fan of roller coasters, you know exactly what I’m talking about. Most coaster fans really like the giant drop at the beginning more than any other part.
Did you know that you have a kind of roller coaster in your mouth every single day? The pH of your mouth is constantly going up and down all throughout the day.
Ideally, your mouth is at a pretty neutral pH, around 7. When you consume something that the bacteria in your mouth can eat, they will metabolize this into an acid. Have you ever noticed after eating a candy bar or something else really sweet that you get a sour taste in your mouth for awhile? “Sour” is the taste that detects acidity. When you notice that sour taste in your mouth, you should realize that there has been a drop in your mouth’s pH. If the pH in your mouth drops below the critical pH (about 5.5 or so), you are at risk for tooth enamel and dentin to start dissolving!
When you draw the drop in pH against time on a graph, it looks like a very steep roller coaster. Once this roller coaster drops past a pH of 5.5, your teeth are at risk for cavities! How quickly does the roller coaster rise past that critical pH again? Well, that depends. In a healthy person with normal saliva flow it’s somewhere around 25-30 minutes. Someone with xerostomia (dry mouth) might stay below this critical pH for significantly longer. Saliva has the ability to buffer the pH in your mouth. A buffer solution keeps the pH more stable and helps to restore the pH in your mouth to a neutral level. So, if you have a healthy saliva flow, you’re at less risk for cavities due to the pH roller coaster!
So, let’s say you want to make this roller coaster ride a little more predictable and a lot less bumpy for your teeth. What should you do?
avoid sweets and acidy foods: sweets and acidy foods (like pop) cause a steeper and deeper roller coaster drop. Whenever possible, avoid these foods. When you are going to eat or drink them, do it along with regular meals.
avoid lots of snacking: you jump on the pH roller coaster every time you eat or drink something. The less often you do, the less time your mouth spends below the critical pH.
chew sugarless gum after meals and snacks: chewing sugarless gum will stimulate saliva flow, and saliva flow can bring a low pH back up to a safe level more quickly than without.
Roller coasters in real life are a blast. The pH roller coaster that goes on in your mouth isn’t as much fun. But, you can take control with these simple rules and you’ll reduce your risk of cavities!
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This is the story of a tooth. A very groovy tooth. It’s also about the patient who is attached to that tooth. You see, I saw this patient last week. She presented to my office with a “broken tooth.”
All dentists know that what a patient thinks of as “a broken tooth” can range from a tiny chip to a huge piece missing. When I saw her on the schedule I didn’t know what to expect, but I did know that she hadn’t been seen at our office for almost 5 years and she had some previous treatment recommended that hadn’t been completed.
The patient told me that she had broken the tooth when she was chewing on something kind of hard. The tooth hadn’t been hurting her before it broke, but now that it was broken, it was kind of sensitive. Especially when she chewed.
Then I took a look. This was a seriously broken tooth! About half of the back side of the tooth had broken off and it was broken all the way down to the gum line. I was actually a little surprised that the tooth didn’t hurt more. Usually when you’ve got a break this big it’s because 1) there is a large cavity that had undermined that part of the tooth or 2) the tooth had a large filling that had come out. The records showed that the tooth had never had a filling before, but we had recommended cleaning out and filling the pits and fissures (aka: grooves) on the bite surface of the tooth. You’ll notice in the photo that this tooth has very darkly stained grooves. This patient is a high risk for tooth decay due to her diet and these deep grooves are a large risk factor for her as well.
You’re probably thinking, “hey wait a second, doc. Almost half of that tooth is broken off. Those pits and fissures couldn’t have caused that! They’re just little tiny grooves! It must have been an olive pit or something!” I was thinking the same thing. So I decided to do a little detective work.
I had a photo taken with an intraoral camera of this tooth from April 2008. It actually showed a little bit of failing pit and fissure sealant hanging in there. Even then you could see those dark grooves. This visit in 2008 was when we recommended she have those grooves cleaned out and filled.
Unfortunately, that didn’t happen. The story picks back up at the beginning of February, 2013. A big piece of the tooth came off when she was eating something hard while watching the Super Bowl. It started hurting a little bit after that, and she knew she’d have to do something.
The tooth did have a lot of decay, and the decay had undermined the broken part of the tooth. How do I know that? Take a look at this photo of the same tooth at a different angle. The hard, outer layer of tooth is called enamel and is much more resistant to decay than the softer, inner layer of tooth, called dentin. Grooves are weakened areas in the enamel and many grooves communicate right into the dentin.
Decay causing bacteria cover the teeth, but they prefer deep, dark wet places. Places like pits and fissures. And since these grooves are actually weakened areas, the bugs and the acid they produce can slip right through the harder enamel layer and start decaying the dentin. You can actually see the path the decay took over time, right through these deep grooves into the soft, defenseless dentin. Over a period of years, this decay grew into a big cavity and undermined the enamel layer above it. Then, on Super Bowl Sunday, the patient bit onto the tooth just right, and crack!The tooth broke away leaving this soft, affected dentin layer.
So that’s my groovy story. It’s kind of a sad story, because the patient is either going to need a root canal and a crown or she’s going to lose the tooth. But like all good stories, this one has a moral. The moral of this story is to have your grooves evaluated! If you’ve got deep pits and fissures, you have a greater risk for this type of decay. And, left untreated, it can cause a lot of dental strife!
Did you find this post groovy? Mysterious? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
“I never pictured gum disease being this GREEN before.”
Most everyone knows about the Incredible Hulk. Mild mannered scientist Bruce Banner was accidentally exposed to deadly gamma rays, but instead of killing him the radiation gave him strange super powers. When he gets injured or angry, he turns into a gigantic, green, immensely strong and almost mindless rage monster. And the angrier he gets, the stronger he gets! Chaos ensues with him attacking and smashing anyone and anything that gets in his way. Cars are thrown, buildings are brought down and cities are often leveled. He only stops smashing things when his fury burns out, he calms down and he turns back into the mild mannered scientist again, wondering what he’s done this time.
The Hulk was one of my favorites when I was growing up. Reading through my comics I would cringe at the stupid bad guys, thinking “dude, you’re making him angry!” So how, exactly, is a comic book antihero similar to gum disease? Stay with me on this one…
Let’s start with the immune system. Your body is constantly being invaded by viruses (think cold season), bacteria and lots of other nasties that you can’t even see. Lucky for you, your immune system is constantly on the lookout and mostly takes care of these attacks without you ever being aware of them.
The immune system has two main parts: the adaptive immune system and the innate immune system. The adaptive immune system is what most people think of when someone mentions “the immune system” and its definitely the part that gets all the headlines. The adaptive immune system is the part of the immune system that learns to recognize individual types of invaders and remembers them so they’re easier to fight the next time they’re encountered. The adaptive immune system is the part that makes vaccines possible and our understanding of it has probably saved more lives than any other kind of medicine.
The innate immune system is a little bit different. It doesn’t recognize specific invaders, it only recognizes the things that it runs into as “self” and “not self.” If the cells of the innate immune system recognize something as “not self,” they attack the invader. In other words, this part of the immune system can’t say, “hey, I recognize you! You’re a chicken pox virus!” It only thinks, “this thing ain’t me! So I have to kill it!”
If you’ve ever had a sliver, you’ve seen the innate immune system hard at work. The redness, pain and swelling that surrounds a sliver are all signs that the innate immune system is fighting the good fight for you. These signs are called inflammation. Inflammation is your body’s reaction to some kind of injury or pathogenic invasion. The cells of your innate immune system have some amazing weapons, kind of like the Incredible Hulk. These cells will dump toxic chemicals on invading microbes or if they can’t to that, they’ll swallow them whole!
Inflammation is usually a good thing and can be the first step in healing an injury or an infection. However, too much of this inflammatory response can actually cause damage to the tissues that the immune system is trying to protect!
Gum disease is primarily a problem with inflammation. It’s actually an inflammatory reaction to biofilm on your teeth and below your gums. The plaque and debris that we try to brush and floss off of our teeth is pretty sticky stuff. It doesn’t really want to be removed. And if it’s left there long enough, it will harden. This hardened plaque is called calculus or tartar. This calculus acts kind of like a barnacle stuck to the surface of your teeth. Worse than that, it usually gets stuck below the gum line. It’s just about impossible for you to remove by yourself. To remove it a dentist or dental hygienist has to use special tools to break it loose from the surface of your teeth.
“Don’t make me angry. You wouldn’t like me when I’m angry.”
So imagine this calculus on the surface of the roots of your tooth like a bunch of tiny slivers. Your innate immune system recognizes it as a bad guy, but cannot remove it. This makes the innate immune system mad. Kind of like when Bruce Banner gets mad. And the madder your innate immune system gets, the stronger the reaction it creates to try and remove this invader. It starts dumping the toxic chemicals it uses to kill bad bacteria and other bugs into the tissues supporting your teeth! These chemicals, along with toxins from the biofilm itself, start to break down the tissues that support your teeth. It’s kind of like you have an angry Hulk smashing around in your gum tissues, but he’s not able to get rid of the bad guys. And this makes him really angry! So instead, he starts attacking YOU!
In the comic books the Hulk only stops his rampage when he calms down. And this goes for your inflammatory response as well. The very best way to calm our “periodontal Hulk” is to remove the junk stuck to the roots of the teeth. If we can remove this stuff, we can usually calm down that response and stop the active destruction of your gums. Just like the end of every Hulk comic, there’s often a lot of destruction to clean up after the Hulk is gone. Many patients have to deal with the severe loss of bone and the supporting tissues of the teeth even after we’ve cleared up the inflammation of active gum disease.
So, what’s the best way to prevent Bruce Banner from turning into the Hulk? Prevention! Don’t make him mad, right? Brushing, flossing and regular visits to the dentist can help you avoid the ravages of gum disease. Catching problems before they become destructive is the best, but even if you have gum disease, it’s not too late to treat it!
Did you find this post incredible? Did it make you angry? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
My fuel light dinged on my way to work this morning. I stopped at the station where I normally fill up and went through the routine. I actually didn’t notice the price per gallon until I was already pumping. The price was $3.34/gallon.
First I thought, “wow! That’s 15 cents less than the last time I filled up! What a great deal!”
Then I thought a little harder, “actually, I remember when I could fill my talk for less than $20. Man, gas is expensive!”
I probably thought it was expensive back then, too. Gas is funny that way. I can’t remember a time where I ever felt like I was getting a great deal on gas. It’s probably because gas is something I need to run my car. If I don’t put gas in there, my car doesn’t run.
I’d prefer not to spend a single dollar on gas. Given my choice, I’d probably spend it on a new smartphone or some nice new shoes. I’d probably go online and research online which smartphone is the best and I’d probably post some photos of my new shoes on Facebook for my friends to see. I’ve never bragged to my friends about my new tank of gas.
Say you head to your dentist’s office to have your teeth examined and a “cleaning.” The doctor takes a ridiculously huge and ugly photo of one of your lower back teeth that shows a giant black filling. He says, “this filling is failing and there’s a cavity under it. In order to fix it, we need to do a crown. It’s going to cost about $1100.”
“Wow…I don’t know what to say. $1100 is a lot of money! And it doesn’t even hurt!”
Now pretend that the dentist said, “this filling is failing and there’s a cavity under it. In order to fix it, we need to do a crown. It’s going to cost about $800.”
I just saved you $300, so you’re probably psyched about the sweet deal, right?
Ummmm…not so much. Is there any number that the dentist throws at you that makes you think, “wow, that’s a fantastic deal on a time consuming and potentially uncomfortable procedure! I think I’ll have two?” Probably not.
Let’s face it…health care is expensive. The difference is that at a dentist’s office you actually know the price of the services that you consume. At your doctor’s office or a hospital, that kind of transparency doesn’t exist. They tell you what you need, you say, “O.K.” and then they send everything to your insurance company. Then you get to play “medical bill Bingo” in a few weeks to see how much you’ll have to write a check for.
Does this look like a root canal?
The more needs you have, the more expensive your treatment will be. A GMC dually pickup has much greater fuel needs than a Prius, and so it’s much more expensive to drive. If you have high risk factors for decay (lots of existing fillings and crowns, lots of mouth drying medications, drink a lot of pop, only visit the dentist when something hurts, etc.), you’re totally driving that dually. Would you prefer the fuel costs of that Prius? Here’s a few tips:
Visit your dentist often! At least every 6 months!
If you have a tooth problem, don’t wait! Call us right away…even if it doesn’t hurt!
Drink pop sparingly. And when you do, consume it at meals or use the “two minute warning” technique.
Ask questions about your dental condition and especially any treatment recommended by your dental team. Make sure you understand the costs of treatment before it starts!
Of course you’d rather not pay for dentistry. Just like gasoline, it ends up on the needs shelf rather than the wants shelf. At least it does if you want to keep your teeth! However now, every time you are waiting for your tank to fill, you’ll think of these hints to keep dental costs down. Curse you, Mead! I used to use that time for deciding what to have for lunch.
Did you find this post filling? Mostly ridiculous? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
No one wants to pay for dental care. Smartphones and cable are funner and sexier. Grown ups take care of needs before wants. Let us help you keep the needs stuff less expensive so you have more left over for the wants stuff!
“I wash my car every week. I never miss. The thing is spotless! But I’m NOT going to change my oil.”
I had a patient that recently presented for a cleaning. For regular recall appointments we do a thorough examination at least once per year. And by “thorough examination” I mean having me come in with my very geeky 6x magnification glasses and ridiculous headlight and look over the teeth, the lips, cheeks, tongue, inside, outside up and down. This patient explained that since she no longer had dental insurance that she did not want to have an exam. She just wanted a cleaning. She was O.K. paying for a smooth, minty feeling that lasts for a day or two. But she didn’t want to see the doctor.
I completely understand about trying to save money. Dental care is expensive. It feels even more expensive because it’s the kind of thing that people don’t want to pay for. If I’ve got to pay for it, I’d rather buy a new cell phone or some new shoes. I don’t know a lot of people that walk into the office just itching to hand over hard earned cash.
The problem is that if the patient really wants to save money, she ought to skip the “cleaning” and keep up with the exams! If she wants to spend less money at the dentist’s office, her best bet is in prevention. Polishing your teeth doesn’t actually prevent problems. Polishing removes the biofilm on your teeth, but a biofilm re-develops in a matter of minutes. Polishing your teeth and making them minty fresh is more like the bow on a gift box. It’s nice and it feels good, but it’s not really the point.
We should probably stop calling those appointments cleanings. The hope is that patients are doing a good job cleaning their teeth every day. A better name for those appointments is recall or preventive maintenance. 6 month recalls (and 4 month or 3 month) are about catching problems when they’re small. Recalls are like the “regular maintenance” that your car requires. The hygienist spends a bunch of quality time removing any buildup of tartar and plaque, but they’re also taking a hard look at all of your teeth. Then, when I come in the hygienist lets me know if she has seen any areas that she’s concerned about. When I’m doing an exam I look at everything (teeth, gums, lips, cheeks, tongue, etc.) under high magnification so I can diagnose problems.
For people who don’t have active gum disease, preventive maintenance appointments are about catching dental problems when they’re small. They’re a great way to remind patients the best way to take care of their teeth, and a lovely way to tell them when they’re doing a good job. For people with active gum disease it’s an important part of evaluating the severity of bone loss around the teeth and whether we’ve been able to slow or stop the progression of bone loss.
So next time you make an appointment to spend some time with your dental hygienist, don’t tell everyone you’re off to “have your teeth cleaned.” Let them know that you’re scheduled for your preventive maintenance appointment, but you’re still pretty psyched about that squeaky clean teeth feeling.
Did you find this post well polished? Shiny? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
If you have dental problems, it’s mostly your fault. And if you want to have less dental problems, it’s your responsibility. It’s not the fault of the dental insurance company. It’s not the government’s responsibility. It’s on you. What you eat and how well you take care of your teeth are decisions that you’re in charge of. And you’re in charge of these decisions for your kids. So, will you rise to the challenge?
“Wow, Doc. Kinda harsh.”
Maybe, but I recently saw a PBS Frontline special called “Dollars and Dentists.” Among other things, it accuses dentists of not doing enough to help poor kids with dental care. I’m hearing this more and more and it really irks me. Because 95% of all dental disease is completely preventable.
What I’m saying is that if you’ve never had a cavity, you can choose to keep that perfect record. If you have gingivitis, you can change that. If you’ve had dental troubles, you can stop the destruction and turn it around. And that goes for your children, too.
“Sure, doc. But, what’s the catch?”
There actually is a catch. If you get a lot of cavities or have gum disease it’s likely that your diet and lack of brushing/flossing have a lot to do with it. You see, tooth decay and gum disease are biofilm infections. Your teeth and anything else in your mouth (crowns, dentures, implants) are covered with a film of bacteria and bacterial products called a biofilm. How much of this biofilm (a.k.a: dental plaque) there is and how healthy it is has everything to do with how much decay and gum disease you experience.
“O.K. Doc, I get the “how much” part, but how can bacteria in my mouth be healthy?”
Once you become in charge of your own health, it’s time to step up. If you’ve been dealt the hand of tough mouth bugs, you’re responsible for changing them! Those who have already experienced dental troubles (cavities or gum disease) need to work even harder on their home care. The very fact that you’ve had dental problems lets us know that you have virulent (bad!) bugs. Brushing and flossing can reduce the number and location of these bugs on your teeth. But how do you change what kind of bugs you have?
Diet has a lot to do with the type of bugs that inhabit your mouth. If your mouth maintains a low pH (acid) for a long period of time, the kind of bugs that can tolerate that environment will become more numerous. What kinds of things keep a mouth acidy? Drinking pop. Specifically sipping pop slowly over a long period of time. Other habits like sucking on hard candies cause this, as well. Bathing teeth in a sugary, acidy environment will not only cause cavities but it creates an environment perfect for the nastier bugs. Changing your dietary habits can make a huge difference on the “environment” you create in your mouth. Reducing sweets, especially pop, as well as reducing how often a person snacks will go a long way to letting your natural defenses change the environment in your mouth. Chewing xylitol gum or mints can also change the kind of bugs you have in your mouth. Dentists can prescribe certain mouth rinses that can actually change the makeup of your biofilm over time as well.
Do it for him!
Your biofilm is your problem. Most people only see the dentist a few times per year. The choices you make on a day to day basis about diet and taking care of your teeth (or not) are the ones that really count. I can’t control what you or your kids eat. We can clean up your biofilm a couple times per year, but it will be back to the same the day after we clean your teeth. The choice is yours. So step up and take care of those teeth!
Did you find this post invigorating? Harsh? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
I was doing an exam on a patient recently. The patient had quite a few silver fillings that were probably 20 years old or older. I had some concerns for some of the teeth. Not because of the age of the fillings. Fillings like these can often last 20 years or more. It was because of the fracture lines I could see.
This tooth exhibits several stained and diagonal cracks. The tooth had no pain.
I put took a photo with a digital camera and it popped up on the screen of the iPad after a couple of seconds.
“This tooth is showing signs of trouble. Can you see these little lines?”
I zoomed in the cracks.
“Those little lines are fractures in the tooth. Incomplete fractures. In other words, it’s a broken tooth waiting to happen.”
“I see, Doc. But it doesn’t hurt at all.”
“Interesting. Sometimes they’re painless. Often they’ll become sensitive on biting, but occasionally they’re free of any kind of symptom until they break.”
“Maybe I should just wait until it breaks. I mean, it doesn’t hurt.”
“We absolutely can do that. A lot of times, nothing bad happens by waiting. If it breaks, we’ll fix it. But sometimes the tooth breaks in an unpredictable way. Like underneath your gum, or even under the bone. When that happens fixing it can involve a crown and a root canal and possibly even gum surgery. Sometimes the tooth can’t be saved if it breaks in a bad way. That’s why I would recommend putting a crown on it before it breaks.”
“How do you know if it’s going to break badly?”
“I don’t. So really, I recommend you fix it the day before it breaks.”
The patient gave me an exasperated look.
An "internal" fracture that was underneath a filling. This tooth had pain on biting.
I know, I know. That is a very cheesy line. I use it all the time because it’s so true. A tooth with this kind of crack, particularly a stained or diagonal fracture is at great risk of breaking. The very best thing we can do for it is to cover it with a crown or onlay. As soon as possible!
In many cases there are internal fractures underneath fillings that have been in place for a long time. Sometimes we don’t see those until we remove the existing filling. These internal cracks are much more likely to be sensitive on biting. Sensitivity to biting is another symptom that shouldn’t be ignored and should be treated right away!
The moral of this story is…don’t wait! A tooth is less likely to have complications (like needing a root canal) if it’s treated as soon as problems are diagnosed. This dentist REALLY prefers no complications!
Did you find this post awesome? Bogus? Excruciating? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
Yesterday ABC played a story in their “Hidden America” series entitled “Do Dentists Turn Children Away.” It’s an emotional piece, for sure. It features many adorable low income kids in various states of dental distress and it levels some pretty serious charges at government and the dental community. Chris Cuomo, the story’s reporter, ended the story with, “…we went after them 5 years ago, it didn’t get done. This time we will not rest. This is unacceptable.” Diane Sawyer replied “And what about the good dentistsout there that want to help the 60% [of children on Medicaid without a dentist] who are living their lives right now and can’t wait…” Chris Cuomo went on to mention that some dentists are “doing the right thing…” The take home message I get from this report is that “dentists don’t care about poor kids.”
This report comes on the heels of ABC’s coverage of “dental x-rays causing brain tumors.” It seems that dentists are getting all kinds of help from ABC news to tarnish our images this month! Like we needed it! So why won’t dentists take care of these needy kids? Is it that they don’t care? Or maybe they’re just unwilling to make less money while helping poor people. Either way, dentists are clearly bad guys.
I can only speak for myself. I’ve discussed this with other dentists often and most tend to agree with my perspective, though. I do take limited amounts of Michigan’s version of Medicaid dental coverage for kids/adolescents/young adults. Why don’t I take more? Here’s a few of those reasons:
limited services: This is probably the main reason that I’m hesitant to get more involved with these programs. I have a toolbox that I bring with me when I treat patients. (Not literally…I actually have an office!) I have a lot of different treatments to offer for different dental problems. Some of these tools work better in some situations, some work better for others. In extensive problems, some of these just aren’t workable. One of the things that frustrates me is that Medicaid will pay for a root canal procedure to save a tooth, but they will not allow you to restore the tooth appropriately after the root canal treatment! A lot of teeth that end up requiring a root canal have lost a lot of tooth structure. A filling is inadequate for these teeth, but that’s what is covered. If I go ahead and do what I feel as appropriate, the program will not cover it and it becomes the patient’s responsibility. Most patients aren’t willing or able to pay for the appropriate treamtent. So, my toolbox gets much smaller for patients using these programs.
limited payment: The fees that the Medicaid programs pay are low. That’s what everyone knows. The news programs always say this, but they never dig any deeper than that. To be specific, Healthy Kids dental in Michigan reimburses my office at about 50% of my regular fee. People hear this and think that dental offices make 50% less when they see kids on the Healthy Kids program. That’s not accurate. Most dental offices are small businesses run to make a profit. A dental office needs to collect a certain amount of money just to pay rent, utilities, equipment costs, employees…the basics. This is called overhead, and every business has it. You need to average a certain number of dollars for each unit of time in order to keep the doors open. If you don’t average this amount, the office doesn’t make a profit. Some offices can change their overhead structure by working more quickly, seeing more patients, using less expensive materials or paying their employees less to make up this difference. I won’t do that. I don’t want to have to change the way I treat patients to be able to participate with the program. My patients expect amazing service and a certain atmosphere and I’m not willing to sacrifice that. You may think that makes me a snob, but I think my patients appreciate it. So, when I see Healthy Kids patients, I’m working for free. The good news is, overhead is figured on an average, so I’m willing to take a loss on some patients. But as I mentioned before, I limit the number of patients I will see on the program.
ethical traps: Medicaid programs give each provider dentist a particular menu of procedures and their associated codes that are covered benefits. It could be tempting for a dentist to “overuse” a code that they wouldn’t normally charge separately for. I’m not saying that it’s wrong to do so and I’m not saying that it is common. All I’m saying is the that the temptation to “overcode” can be there.
All kids deserve healthy teeth!
dental prevention: Most dental diseases, especially in children are 100% preventable. These programs are at their absolute best when they are used for prevention: specifically early childhood examination and education of good dietary and brushing habits. Unfortunately, most people end up in need of these services after a child has problems, often really bad problems. The horse is already out of the barn at that point. These programs become much less helpful for those patients, and they will often need extensive care that can only be handled by pediatric dentists.
This is where I’m coming from. I’m not sure it would be a satisfying answer for Diane Sawyer. It’s a lot better TV when you can point the finger of blame at a particular group, especially when a lot of folks are pretty anxious about that group in the first place. The news media plays a story that riles people up, and then they forget about it. In the mean time, people look at dentists as greedy and uncaring. If you feel like dentists aren’t doing good things for poor kids, you need to ask yourself: in the same position, would you be willing to work for free? How much work would you be willing to do for free?
The Michigan Dental Association will be sponsoring it’s first Mission of Mercy in June of 2013. These amazing events allow Michigan dentists to see around 2000 patients in a weekend for no charge. Next year’s Mission of Mercy will be held on campus at Saginaw Valley State University. I’m planning on being a part of the 2013 MOM. I think this kind of event is an effective way to help people who might otherwise not be able to get dental care. So Diane Sawyer might have it wrong about dentists!
Did you find this post frustrating? Thought provoking? Angering? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.