THE MOUTH

The Missing Piece to Your Overall Wellness and Lower Medical Costs

New research by insurance giant United Concordia builds on the connection between good oral health and lower medical costs and reduced hospitalizations.  This landmark study was conducted through a partnership between United Concordia Dental and Highmark, examining three years of medical and dental claims for 1.7 million members.[1]

Chronic medical conditions are a widespread issue in our country, affecting an estimated one out of every two adults over 21.[2] And, periodontitis (gum disease) is an epidemic of its own:

47% of Americans suffer from periodontal disease at any one time[3]

The good news is, United Concordia’s study found that regular professional dental care can not only improve overall health, but can also reduce your medical expenses and hospitalizations.

What this means for patients in our Sandy Springs office who have one or more chronic conditions or  are pregnant is:

If you have a chronic condition, such as type 2 diabetes, heart disease, stroke or pregnant, it is more important than ever to keep up with consistent oral care at home and see your dentist regularly. You many need additional treatment to keep your mouth healthy, which can help improve your overall health, and keep your medical costs down.[4]

How we make better oral health a part of your overall wellness.

The basics of good dental care are relatively simple—brush twice day, floss once a day and see your dentist. But, it’s also important to follow your dentist’s recommendations for treatment.  With over 90 years of experience in metro Atlanta, we have long understood that the mouth is connected to the body, and with better oral care and our expertise, you could see improvements in your overall health, plus savings in medical costs and reduced hospitalizations.

The opportunity for cost savings and better health is significant.  Routine oral care helps prevent and respond to problems before they develop into complex and more expensive ones.  Without a doubt, good professional oral health care is critical to your overall health.  If we can be of assistance, do not hesitate to contact us.

ZoAnna Scheinfeld, MS, DMD

290 Carpenter Drive, 200A

Atlanta, GA 30328

404-256-3620

info@rightsmilecenter.com

www.rightsmilecenter.com

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[1] This study shows reduced hospitalizations and health care costs are possible when individuals with at least one chronic condition or who are pregnant receive treatment for their gum disease. Having the study peer-reviewed speaks to the importance of the findings and the credibility of our work." -Dr. Marjorie Jeffcoat, D.M.D.

[2] CDC, The Power of Prevention: Chronic Disease…the Public Health Challenge of the 21^st Century,  2009

[3] CDC, Prevalence of Periodontitis in Adults in the United States: 2009 and 2010, 09/12

[4] Published in American Journal of Preventive Medicine

How Often Should I See the Dentist?

At least every six months.

There are those who are at greater risk for oral diseases and other health related issues that should have dental cleanings and oral health check-ups more than twice a year, such as, diabetes, periodontal (gum) disease, possible heart disease, pregnancies and in rare instances alcohol and tobacco users.

Poor oral hygiene and certain medical conditions are some of the many factors that your dentist takes into consideration when deciding how often you need your dental cleaning and check-ups.  One of the real problems that has invaded oral healthcare are the restrictions placed on insurance coverage by insurers.  You need to understand that insurance companies serve a self-interest in reducing the number to times you visit your dentist.  More than not, our ability to be oral health care providers is hindered by what your insurance dictates.  We recommend you try not to let what your insurance covers be your benchmark for your healthcare.  It could result in expanded dentistry in the long run.

Going on a regular basis will help to keep your oral health on track as well as detect any early signs of periodontal disease, oral cancer or cavities.  In our Sandy Springs office we recommend the best way to maintain good oral health is to visit your dentist on a regular basis coupled with brushing your teeth, flossing and drinking fluoridated water

.

Seeing patients from all over metro Atlanta I sometimes like to joke, ‘the best toothbrush is the one you use’ and ‘brush the ones you want to keep’.  But in all seriousness, if you live in nearby Dunwoody, Roswell or East Cobb, please, if we can help feel free to call us.

ZoAnna Scheinfeld, MS, DMD

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

Your Teeth - your step child. Dentist Sandy Springs

Here is the biggest lie propagated about healthcare and insurance companies.

“Edentulism[1] is not a risk factor for any other diseases, so it is not a liability to the overall health of a patient.”

That’s a lie that has been propagated for decades.  Bad teeth and long-term low-level infections can damage your lungs and heart, lead to increased and/or chronic lung infections and even lead to sepsis; death in extreme cases. In a cross-sectional study, Hamasha and others found significant differences between edentulous and dentate individuals with respect to rates of atherosclerotic vascular disease, heart failure, ischemic heart disease and joint disease.[2]

As a consequence of a lack of certain nutrition due to altered eating habits, various health problems can occur, from the mild to the extreme. Lack of certain vitamins (A, E and C) and low levels of riboflavin and thiamin can produce a variety of conditions, ranging from constipation, weight loss, arthritis and rheumatism. There are more serious conditions such as heart disease and Parkinson's disease and even to the extreme, certain types of Cancer.

The absence of teeth can damage your jaw bone’s structure.  In addition, the tongue, which consists of a very dynamic group of muscles, tends to fill the space it is allowed, and in the absence of teeth, will broaden out.  And the most ludicrous thing today that exemplifies the attitude I quoted, above, is that Medicare won’t pay for any dental work, or dentures – yet it will pay for a male erection (Viagra.)  Go figure.

If we can help you, please contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta, GA 30328

404-256-3620

info@rightsmilecenter.com

www.rightsmilecenter.com

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[1] Edentulism is the condition of being toothless to at least some degree.

[2] Hutton, Feine, Morais, 2002

Dental Care saves your Money and your Health – Sandy Springs Dental Care

United Concordia and Highmark funded a study led by Dr. Marjorie Jeffcoat of the University of Pennsylvania School of Dental Medicine that shows how dental and medical insurance industries can come together to have an impact on both cost and health.  This study is a largest of its kind, conducted using a base of 1.6 million people and including information for three years. It is the most statistically conclusive study proving the relationship between oral health and medical cost savings.

An analysis of insurance records over a 3 year period showed significant reductions in both medical costs and hospitalizations for patients who received periodontal care.  “[T]hat simple non-invasive periodontal therapy can improve health outcomes in pregnancies and other systemic conditions.”[1]  With respect to diabetics, the mean number of visits that patients went to see their physicians was half the number of physicians' visits of those who did not have periodontal treatment.

Periodontal disease is an infection. It has to do with the inflammation. It has to do with infection and getting it under control.  Periodontal gum diseases are preventable and are treatable at a much lower cost than hospitalization and health care for more global diseases and infections.

About 30 percent of the nation’s healthcare dollars are spent on hospital care, about 22 percent on physician and clinical services, and about 11 percent on prescription drugs.  Dentistry on the other hand accounts for only about 4 percent of the national healthcare spending.   So if you – if we can get in and improve the spending in the dental, that’s going to affect the three other largest segments of the healthcare spending.   If we can be of service with your oral health care please give us a call for your complimentary assessment.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta, GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

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[1] Marjorie Jeffcoat, DMD, Professor of Periodontics and Dean Emeritus at the university of Pennsylvania. 

Dental Insurance? Not. Sandy Springs Dental Care

Give me a break.  Dental insurance plans are a business arrangement between the insurance company and an employer.  Unfortunately, the reimbursement and benefit levels are based on carrier and employer business decisions, and not on your need for treatment.  At best, it pays for 2 cleanings and very little after that.  Most plans have a maximum benefit of between $1,000 and $1,500 per year, which is a far cry from what you really need for your oral health care.

These benefits (I use that term loosely) haven’t changed since the 1980’s.[1]  It’s ridiculous to tie your dental provider’s hands with reimbursements that haven’t risen in 35 years while the cost of living has increased dramatically in comparison.  Patients that have major restorative or surgical needs or bite dysfunction cannot afford to delay treatment and spread it over multiple insurance plan years, because their condition may worsen if not treated immediately. And none of the reimbursements take into account the added costs of HIPAA, associated and new technologies.

Like medical insurance, some dental plans do not offer coverage for pre-existing conditions, such as missing teeth. This type of plan would not cover tooth replacement procedures, such as bridges, partial dentures, full dentures or dental implants.  And the continued absence of tooth structure will result in the continued resorption of the jaw bone, further complicating the possibility of restoration.

Many insurance plans will unilaterally apply “alternate benefits” towards your service, such as paying for amalgam fillings rather than tooth-colored composite fillings, or, not covering major restorative services, such as a crowns, inlays, or Cad/Cam restorations.

Because insurance carriers are exempt from anti-trust laws, most dental plans use the terms ‘usual, customary and reasonable’ to determine your insurance benefits.  This term applies to fee manipulation used by dental insurance carriers to set reimbursement levels across the country. The criteria upon which this research is based, including region, time intervals, type of dentist, etc., vary greatly from one insurance carrier to the other.

Unfortunately, under the current system there are very few dental insurance benefits that actually benefit you.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta, GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

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[1] http://www.bls.gov/opub/mlr/cwc/dental-care-benefits-1995.pdf

Sandy Springs Dentist: How often should I get my teeth cleaned?

Good question because there is no simple answer.  That’s not what you thought the answer would be. However, I read a recent article suggesting that one cleaning per year may be enough for a certain portion of our population.  And yet the article suggested that for those with one or more of the three risk factors – smoking, diabetes and genetics- 2 dental cleanings would be necessary.  And for the segment of our population with 2 or more of the 3 risk factors, more than two times a year may be needed.  So where do you fit in, are you zero or three for risk factors?[1]

What the study failed to address is a genetic factor that would necessitate 3 or more visits per year?  We know there are those who are at greater risk, but we don’t have a scalable method to determine those with increased risk and those who are not at risk.  And to compound the issue, the insurance companies won’t allow dentist to diagnose for the difference.  Each patient presents a unique set of characteristics, but is treated by insurance companies in a cookie cutter approach.  As a result both patients and doctors are left to navigate what would otherwise be personalized medicine.[2]

As a health care provider I tried to distance myself from what the insurance industry dictates and stay true to my professional teachings.  However, we as a society need to change how we look at our global health care system.  One of the aspects the study failed to address is that Concordia Insurance has found that those patients who seek routine oral care on a regular basis reduce their overall health costs and improve their global health. So by correlative analysis, it would make sense to see your dentist at least twice a year.

If we can help you determine a more personalized treatment please give us a call, because what your insurance will pay is at the bottom of consideration in our practice.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

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[1] http://www.webmd.com/oral-health/news/20130610/annual-dental-cleaning-may-be-enough-for-some-study

[2] Ibid.

Dentist East Cobb: Dental Advice for Moms-To-Be

Expecting a baby is a very exciting time, and you're already on the right path if you’re staying on top of your dental health. With the proper dental care measures, you'll increase your chances of having a smoother pregnancy, full-term delivery and healthy baby.

If you're planning to get pregnant, consider having your teeth cleaned and any restorative dental treatment done first. If you are already pregnant, be sure to tell your dentist before getting any work done. You should also have a dental checkup at least once during the pregnancy. Although dental cleanings aren't harmful, it's recommended that expecting mothers get them done during the second trimester to reduce the risk of complications.

According to the American Dental Association (ADA), it's best to postpone dental work during the first and third trimesters as well, as these are critical periods for the baby's development. Your dentist will let you know what dental treatments can be performed during the second trimester, but more complicated procedures will probably be postponed, if possible. Unnecessary treatments, such as cosmetic dental work, should be avoided altogether.

If you do have an unexpected dental problem or emergency, make an appointment with your dentist as soon as you can. Your dentist will look for signs of infection and determine the need for treatment. Dental X-rays are usually avoided during pregnancy, but if photos are necessary, your dentist will take extra precautions to protect your baby.

Just as dental health is connected to your overall health, dental care is important to the health of your unborn baby. It's extremely important to take care of your teeth during pregnancy, as some dental problems can increase the risk of complications.

The best advice is to make sure your dentist is part of your baby’s pre-natal care team from the beginning.  If we can answer any questions or concerns please feel free to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

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Sandy Springs Dentist: Oral Health During Pregnancy

Apparently, oral health care during pregnancy is often misunderstood by treating physicians, dentists, and their patients. Every pregnant woman should be screened for oral risks, educated about proper oral hygiene, and referred to a dentist where treatment may be necessary.[1] Dental procedures such as periodontal treatment, restorations, and extractions are safe and are best performed during the second trimester. We are hesitant to perform diagnostic radiography regardless of the accepted practice that its safe.  Xylitol and chlorhexidine[2] may be used as adjuvant therapy for high-risk mothers in the early postpartum period to reduce transmission of cariogenic bacteria to their infants.[3] Appropriate dental care and prevention during pregnancy may reduce poor prenatal outcomes and decrease infant caries.[4]

Every pregnant woman should be assessed by a dentist for dental hygiene habits, access to fluoridated water, oral problems (e.g., caries, gingivitis), and continued access to dental care.[5]  Patients should be counseled to perform routine brushing and flossing, to avoid excessive amounts of sugary snacks and drinks, and to consult a dentist.[6]  Many dentists are reported to be reluctant to treat pregnant women.[7] Optimally, physicians and dentists can overcome this situation through education, clear communication, and the development of ongoing collaborative relationships. Physicians can share information on the safety of dental treatment in pregnancy with dental colleagues and provide clear referral recommendations.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

info@rightsmilecenter.com

www.rightsmilecenter.com

Related articles

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[1] http://www.mchaccess.org/pdfs/alerts/oral%20health%20during%20pregnancy.pdf.

 

[2] Teratogenic Effects Pregnancy Category B. Reproduction studies have been performed in rats and rabbits at Chlorhexidine gluconate doses up to 300 mg/kg/day and 40 mg/kg/day, respectively, and have not revealed evidence of harm to fetus. However, adequate and well-controlled studies in pregnant women have not been done. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. http://www.drugs.com/pro/chlorhexidine.html

[3] http://www.mchaccess.org/pdfs/alerts/oral%20health%20during%20pregnancy.pdf.  HUGH SILK, MD, University of Massachusetts Medical School and Family Medicine Residency Program, Worcester, Massachusetts. ALAN B. DOUGLASS, MD, Family Medicine Residency Program, Middlesex Hospital, Middletown, Connecticut.  JOANNA M. DOUGLASS, BDS, DDS, University of Connecticut School of Dental Medicine, Farmington, Connecticut.  LAURA SILK, MD, Health Alliance, Leominster, Massachusetts.

[4] Am Fam Physician. 2008;77(8):1139-1144. Copyright © 2008 American Academy of Family Physicians.

[5] Oral examination should include the teeth, gums, tongue, palate, and mucosa.

[6] http://www.mchaccess.org/pdfs/alerts/oral%20health%20during%20pregnancy.pdf.

[7] Livingston HM, Dellinger TM, Holder R. Considerations in the management of the pregnant patient. Spec Care Dentist. 1998;18(5):183-188

Atlanta Dentist: Clark Howard or Real Oral Health Care?

In response to Clark Howard’s opinion on dentists and mid-level providers, he’s dead wrong or could be.[1]  And he doesn’t understand the sector of patients who do and don’t seek to have proper oral health care.  If Mr. Howard had a heart-attack today, price of care would be the last thing on his mind.  Would he negotiate before they installed the stint or after?[2]  His perspective is steeped in ignorance. The answer is not as Mr. Howard would suggest, devoting energy and time and money to creating a lesser trained dental provider to deliver a poor approximation of comprehensive dental care (in Georgia). [3] This opinion comes from the lack of understanding of what a dentist is trained to do.  Clark Howard is living back in the 20’s, the 1820’s, where the only thing a dentist did was pull teeth and cut hair.

A recent example in our office was the discovery of suspicious cells on the underside of the patient’s tongue.  Ultimately (and hopefully), our discovery and recommendation will save this patients life.  Our early detection of cancer comes from years of (university) training and experience that transcends the old view of what a dentist does for that 15 minute examination during your regularly scheduled hygiene appointment.  Contrary to your physician’s health care, the cost of delivering dentistry is under constant pressures from the free market system.

The answer to providing adequate and broad based oral health care lies in educating patients about the value of good oral health, who can best deliver the care, and how consumers can obtain and maintain that care.  Marred by an old view of dentists and dentistry, Mr. Howard is stuck in a mindset that all dentists do is just drill-and-fill.  There is much more to the art and science of dentistry than Clark Howard is remotely aware.

Our society needs to understand the need to regularly maintain their oral health and that dental care for them and their families is not optional.  We need to instill in our society the need to maintain an oral health care regimen and visiting the dentist is a part of that regimen.  I find it interesting that Clark Howard wants to put you in a position where you bargain for your health care needs.[4]  Where he fails in his advice is to differentiate between oral health care and retail dentistry.

With regards to the specific point of creating mid-level providers as has happened in Alaska, census data demonstrates that 43% of our “public” health care providers aren’t busy because patients don’t show up for their appointments. This is not a lack of dentists, rather a lack of utilization of the care available.  While there is no empirical evidence as to ‘why’, one would speculate it is because like Mr. Clark Howard, a large portion of the public fail to value the real benefits to oral health care.  Take a credible, but uninformed spokesperson like Clark Howard, and the notion that all dentists do is drill-and-fill and we, as providers are starting 10 yards behind the starting line.

The real solution is better patient education.

If we can answer your questions or you have comments, please feel free to weigh in on this matter.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

info@rightsmilecenter.com

www.rightsmilecenter.com

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[1] http://www.clarkhoward.com/news/clark-howard/health-health-care/dentistry-too-expensive-for-many-americans/nCpN/

[2] http://www.clarkhoward.com/news/clark-howard/health-health-care/negotiate-better-deal-dentistry/nFyQs/

[3] http://www.clarkhoward.com/news/clark-howard/health-health-care/dentistry-too-expensive-for-many-americans/nCpN/

[4] This isn’t to suggest that we as a discipline of health care aren’t competitive.  The free market system has kept dentistry fairly moderate in terms of cost compared to the annual leaps in insurance coverage and physician/hospital care.

Dentist Dunwoody: Oral Health, Women and Pregnancy

More than 6 million women in the US become pregnant every year and 40% of them for the first time.  During pregnancy, women are at greater risk of experiencing poor oral health care, which has been linked to adverse pregnancy outcomes.  Pregnant women are susceptible to oral infections, pregnancy gingivitis, periodontitis and oral pyogenic granulomas.  Results of various studies regarding oral health literacy show it is directly related to general health knowledge, and therefore, health outcomes of both the mother and the fetus follow the level of the mother’s health knowledge.  These studies show that the prevalence of low health literacy among pregnant women ranges from about 15 to 38% and is associated with older age women and women of minority status.[1]

Because of the low levels of oral health knowledge among these segments of the population, it is important for physicians and public health workers to be aware that a message should be tailored to direct pregnant women in these at-risk populations to seek out dental professionals[2] who can alleviate potential oral health issues that might be related to complications in their pregnancies and the potential of adverse effects on their babies.

If you have any questions or concerns about your oral health care, please do not hesitate to contact us via email or by phone.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

Thank you for all your referrals.  We truly appreciate them.

Information included is not dental or medical advice.  For your specific information

 be sure to consult your dentist.

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[1] Jada, September 2012 at 972-979

[2] We have an in-house periodontist should the need arise.

East Cobb, GA: Dentist: New Directions in Oral Health Care

The hygienist plays an intricate role in your oral health care.  At a minimum the role includes periodontal disease evaluation, taking x-rays and a patient’s periodontal charting.  Traditionally, they engaged in cleaning and flossing the teeth under the theory that at healthy mouth was primarily necessary for the patient to keep their teeth.  While this is still the case,  discoveries in the last decade have uncovered the correlation between periodontal disease and other health related issues such as diabetes, Alzheimer’s, cardiovascular disease, pregnancy related problems that assigns new priorities to the role of the hygienist and your dental visits.  These correlations have caused a new focus on evaluating a dental patient and new signals related to their overall health.   “The American Academy of Periodontology seeks to educate the public about research findings which support what dental professionals have long suspected: Infections in the mouth can play havoc elsewhere in the body. For a long time it was thought that bacteria was the factor that linked periodontal disease to other infections in the body; however, more recent research demonstrates that inflammation may link periodontal disease to other chronic conditions. Research has shown, and experts agree, that there is an association between periodontal diseases and other chronic inflammatory conditions, such as diabetes, cardiovascular disease and Alzheimer’s disease. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.” [1]

The U.S. Surgeon General agrees that oral health is a strong indicator of one’s overall health and well-being.[2]  Often, diseases give their first warning signs in the form of a patient’s oral problems.  Without consistent care and monitoring, several oral health problems can result.  Immediate risks include gingivitis, cavities, tooth decay, and other gum diseases which can eventually result in various types oral cancer.  There is a “silent epidemic”[3] that can be avoided by regular treatment at home and dental visits at least twice each year.  While practicing good oral hygiene at home is vital to your health, there is only so much that personal oral maintenance can do.  A normal person can easily overlook conditions that could greatly complicate or even end one's life.  Thus, visiting your dentist for regular checkups is vital to a healthier smile.

"Routine dental exams uncover problems that can be easily treated in the early stages, when damage is minimal".[4]   Now that it is known that gum disease can be a major risk factor for heart disease, stroke, and certain forms of cancer, regular visits to your dentist can help prevent and treat this disease.  By treating conditions early and learning from your dentist how to prevent oral diseases, you can achieve better health and ultimately better quality years of life.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328                                                                                            

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

Serving residents in East Cobb, Roswell, Alpharetta, Johns Creek, Dunwoody, Buckhead and surrounding communities.

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[1] (www.perio.org).

[2] (CDC, 2006).

[3] (U.S. Surgeon General).

[4] (American Dental Association [ADA], 2008).