Posted on 30. Aug, 2011 by wisdom.
I wanted to let anyone who might be interested in free dental care that recently 1dental.com put together a tool that allows one to enter their zip code to search for free dental care providers in their area.
This tool is available at http://www.1dental.com/provider/. It allows different specialties to be searched for as well such as general dentists, oral surgeons, pediatric dentists, orthodontists, periodontists, and endodontists.
This tool will provide a phone number and a convenient Google map.
Of course it should be mentioned that 1dental sells dental plans so they try to get you to sign up with the Careington Dental plan.
I personally have not used this tool to find a dentist and have no experience with Careington Dental plan. Therefore use at your own discretion. It may help some looking for and in need of dental work.
There is also a program called Give Kids a Smile which in the past few years has provided free dental care for 2 days in February and 2 days in October for those children in need. More information and event listings are available on the Give Kids a Smile website.
There is another program called Dentistry from the Heart which in 2010 had over 200 events across the United States and Canada where free dental care was provided to those in need. Event listings are available on the Dentistry from the Heart website.
An article is titled Medical Professionalism in the New Millennium: A Physician Charter in the Annals of Internal Medicine, vol. 136, no. 3, pages 243-246, February 5, 2002, http://www.annals.org/content/136/3/243.full?ijkey=49cf14ffb35a6afdba3a14871f01fb39ad23066f&keytype2=tf_ipsecsha
In the second paragraph appears the words:
“…conditions of medical practice are tempting physicians to abandon their commitment to the primacy of patient welfare”
The article then goes on to discuses a preamble
“Professionalism is the basis of medicine’s contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society on matters of health. The principles and responsibilities of medical professionalism must be clearly understood by both the profession and society. Essential to this contract is public trust in physicians, which depends on the integrity of both individual physicians and the whole profession.”
The article talks about 3 fundamental principles of medical professionalism:
- Principle of primacy of patient welfare
- Principle of patient autonomy
- Principle of social justice
The article then discusses a set of Professional Responsibilities
- Commitment to professional competence
- Commitment to honesty with patients
- Commitment to patient confidentiality
- Commitment to maintaining appropriate relations with patients.
- Commitment to improving quality of care
- Commitment to improving access to care
- Commitment to a just distribution of finite resources
- Commitment to scientific knowledge
- Commitment to maintaining trust by managing conflicts of interest
- Commitment to professional responsibilities
The second to last sentence of the article ends with
“To maintain the fidelity of medicine’s social contract during this turbulent time, we believe that physicians must reaffirm their active dedication to the principles of professionalism, which entails not only their personal commitment to the welfare of their patients but also collective efforts to improve the health care system for the welfare of society.”
As indicated clearly on my website many physicians need to take the time to reaffirm their dedication to professionalism and perhaps reassess why they went into medicine.
As indicated current scientific knowledge does not support or refute the extraction of healthy wisdom teeth except for under clear indications. http://www.teethremoval.com/controversy.html. However the American Association of Oral and Maxillofacial Surgeons (AAOMS) continues to not provide this information on their website regarding wisdom teeth http://www.aaoms.org/wisdom_teeth.php
An article is titled Government Policies in Violation of Human Rights as a Barrier to Professionalism in JAMA, vol. 306, no. 5 pages 541-542. August 3, 2011, http://jama.ama-assn.org/content/306/5/541.full
In the article it says
“However, deeply embedded institutional and organizational impediments often beyond the control of the physician (eg, inequitable access to care and reimbursement systems that create disincentives to proper care) can undermine physicians’ ability to adhere to these professional obligations in clinical practice”
Clearly much work still needs to be done.
Additional Source: Professionalism, social justice, and the primacy of patient welfare. Don McCanne MD, Friday, Aug 12, 2011, http://pnhp.org/blog/2011/08/12/professionalism-social-justice-and-the-primacy-of-patient-welfare/
Posted on 15. Aug, 2011 by wisdom.
On August 12, 2011, the American Dental Association (ADA) released the second paper in their series of papers on access to oral health.
The paper is available for download from the ADA at http://www.ada.org/sections/advocacy/pdfs/breaking-down-barriers.pdf
The first paper released on February 22, 2011, was titled Breaking Down Barriers to Oral Health for All Americans: The Role of Workforce as available for download from the ADA at http://www.ada.org/sections/advocacy/pdfs/ada_workforce_statement.pdf. I have previously commented on this first paper here http://blog.teethremoval.com/breaking-down-barriers-to-oral-health-for-all-americans-ada-workforce-statement/
Like the first paper, in the opening of the document is a message from Raymond Gist, D.D.S. and President of the American Dental Association. In this message Dr. Gist states
“…increasing numbers of Americans find themselves unable to pay for dental care….For this growing population, the so-called oral health safety net is the only recourse for preventing and treating oral disease….the general definition of safety net is the sum of the individuals, organizations, public and private agencies and programs involved in delivering oral health services to people who, for reasons of poverty, culture, language, health status, geography or education, are unable to secure those services on their own…..With the acknowledgment that change to the current system is necessary and is a process and not an event, the ADA is determined to lead what must be the concerted efforts of not only the dental profession, but also governments at all levels, the private and charitable sectors, and all Americans with the will and desire to achieve the goal of a healthier, more productive nation. If all of the stakeholders involved keep that goal at the forefront of our thinking and actions, we can truly progress toward better oral health for all Americans.”
The paper goes on to discuss the safety net for the roughly 82 million people in the U.S. in low income families of which only 27.8% visit the dentist each year.
The ADA is adamant about keeping non-dentists from not providing dental services such as extractions and restorations”
“The ADA remains unequivocally opposed to proposals for these so-called “midlevel providers,” believing that adding lesser-trained “surgeons” to the workforce has the potential to erode the superlative quality of American dental care….The problem is not how many dentists there are; but rather where they are, and whether they are able to serve disadvantaged patients, either in private practices or in connection with clinics, health centers or other facilities.”
The ADA believes that Americans don’t take their oral health seriously:
“Major improvements in the dental safety net will not occur until the nation places greater value on oral health. Despite a growing appreciation in many quarters that oral health is integral to overall health; it remains the poor stepchild of health care in America. This phenomenon extends from government to the media to other health professions to the public at large. This lack of recognition of the importance of oral health is manifest in government policy, in public and private health plans, in the educational system and even in the priorities that individuals set for themselves and their families.”
Unfortunately I think the ADA is thinking and focusing on issues here without recognizing that there other issues that need to be addressed in the current system. As illustrated in the first paper dentists, oral surgeons, and doctors/physicians in private practice in the U.S. clearly have some financial incentives which are in opposition to achieving the goal of a healthier nation. This is simple economics and understandable.
As eloquently put by someone who suffered from a constant headache after having wisdom teeth removed just like myself:
“In our society, protection from liability is primary, profit is secondary, preserving the posterity and ego of the medical profession is tertiary, and treating the patient is somewhere further down [the] priority chain.”
I have recently added a case to the complications from wisdom teeth page where a patient recently had wisdom teeth extracted by an oral surgeon and suffered from a scar on her cheek likely from thermal injury from the dental drill during surgery. She did not know about the injury until after surgery and was told by the oral surgeon’s office the “…condition was not related to the surgery. ” I had a similar experience when I had my wisdom teeth extracted. When I went back to my oral surgeon after having my wisdom teeth extracted preventatively at the age of 20 complaining of a chronic severe 24/7 headache I was told the headache was not from the surgery and to see my family doctor.
Both in my case and the case I just discussed where the woman suffered a thermal burn, there was no access to the court system of the United States. There is no such system that will pay patients who suffer from injury. In my case I had a 24/7 headache develop. This certainly has and will continue to happen to others who have wisdom teeth extracted in the name of prevention. No technology allows for a headache to be “seen” thus this makes it very difficult to have any sort of malpractice case or recover any fees.
Does it not make sense to focus on fixing some of the problems with the current system? I believe it is time for a no-fault insurance compensation system to be in place in the U.S. Such a system has been successfully implemented in New Zealand. http://www.commonwealthfund.org/Publications/In-the-Literature/2006/Feb/No-Fault-Compensation-in-New-Zealand–Harmonizing-Injury-Compensation–Provider-Accountability–and.aspx
The ADA Repairing the Tattered Safety Net document states:
“A public health model based on the surgical intervention in disease that could have been prevented, after that disease has occurred, is a poor model. The nation will never drill, fill and extract its way to victory over untreated oral disease. But simple, low-cost measures like sealing kids’ teeth, educating families about taking charge of their own oral health, expanding the number of health professionals capable of assessing a child’s oral health, and linking dental and medical homes will pay for themselves many times over.”
Unfortunately, the current system in the U.S. allows for any young adult to go into their dentist or oral surgeon’s private office and have their wisdom teeth removed in the name of prevention. Then if they suffer a chronic, severe 24/7 headache which severely impacts their life and future earning potential they have no access to receive any compensation and their is no universal healthcare system in the U.S. as it is not considered a right. Of course other possibilities are possible.
I have hence argued that the U.S. needs a single-payer health care in the United States, such as what is advocated by the Physicians for a National Health Program http://pnhp.org/, although this comes with many challenges as well. The U.S. most certainly needs a major overhaul of the legal system as argued on the page of how the current U.S. legal system rewards doctors for malpractice.
The ADA needs to refocus it’s efforts on removing profits from patient care in the U.S., allowing the people who have been injured compensation, dentists and doctors respecting and being ethical in their treatment of patients, and most certainly allowing all patients a right to have dental and health care. I can not and will not advocate for surgical extraction of healthy wisdom teeth unless there is clear scientific evidence to demonstrate that removing healthy wisdom teeth preventively is beneficial. Does not the ADA believe in scientific evidence? Current scientific evidence does not support nor refute preventative healthy wisdom teeth extractions and some argue:
“…removing organs such as tonsils and appendices for preventative reasons when they are healthy, have no pathology, and cause no symptoms would be irresponsible, unethical, and negligent and wisdom teeth should be in that category of organs.”
Now certainly this may not apply to all those low income families the ADA talks about in their report who do not regularly see the dentist. The majority of low-income patients maybe should be having their healthy wisdom teeth extracted preventatively particularly those who are uneducated and do not make their oral health a priority which may simply be do to not having the financial resources to do so. However, for the rest of the population particularly in those motivated and educated about making their oral health a priority it seems in most cases to be better served with a strategy of watchful monitoring of healthy wisdom teeth. This is an unfortunate reality of the current state of affairs in the U.S. and I hope and pray that very soon things will change for the better.
I am open to comments and criticisms. Post a comment below or send me an email.
Posted on 07. Aug, 2011 by wisdom.
This story may sound a bit bizarre but actually is true.
In the 1989 a U.S. Air Force veteran requested copies of his dental treatment records from the Department of Veterans Affairs Medical Center in New Hampshire. He believed he had dental treatment at this facility in 1981 and
“….sought his dental records because he believed an electronic eavesdropping device had been planted in his mouth after his wisdom teeth were removed.”
Unfortunately at this time the medical records were on paper and the dental records never turned up.
So I guess this begs the question of whether or not a listening device can be planted in a tooth extraction socket. I think the technology may be there and it may be possible but I highly doubt this a common occurrence.
I suppose this could be possible with a radio-frequency identification (RFID) microchip and there could even be Global Positioning System (GPS) tracking capabilities. This could allow for someone to observe and hear everything the person with the chip hears via a microphone and also know their exact GPS position in the world.
There are certainly many ethical issues raised with such a device and certainly possible negative health effects such as cancer. Even so as technology advances in the future this is certainly a cause for concern. Involuntary microchipping certainly should not be occurring.
See for yourself about the Verichip discussion on Fox News in the YouTube video embedded below
Source: James M. Mooney v. Veterans Administration, No. 90-1628, United States Court of Appeals for the First Circuit, December 3, 1990.
The ADA (American Dental Association) has a video podcast series called Straight from the Mouth.
The second video is titled “Overcoming Dental Anxiety.” http://ada.org/straightfromthemouth.aspx
The press release from the ADA on this podcast was posted in September 28, 2009. http://ada.org/3241.aspx. However, it still says on the Straight from the Mouth Video Podcast that many other videos are coming soon. It seems like the ADA may have decided not to have these podcasts come out or they just haven’t posted them. If anyone has any information let me know.
The podcast is hosted by two dentists Ruchi Nijjar Sahota and Eric Grove. It seems appropriate to younger audiences and is upbeat.
The video is important for many of those who suffer from dental anxiety. It discusses needles, drills, and water used for dental procedures.
Needles of course are used to anesthetize nerves to prevent pain during extractions, root canals, and filling cavities.
The dentists chime in to suggest the viewer asks for a gel to be applied and/or to keep the dental instruments out of your vision to help with fear of needles.
Regarding fear of drills, there is a discussion of bringing your MP3 player to help drown out the noise and a mention that an electric drill can be quieter.
Regarding fear of water and potential choking there is a discussion of telling one’s dentist about any water in their mouth that may be causing difficulty breathing, the suggestion of the use of a dental dam, and discussion of a technique to help one breathe with water in their mouth.
Of course the main goal with this video is to encourage those to not neglect their teeth and gums and see a dentist regularly to help with prevention and aid in early detection of any diseases/problems. This of course should be in addition to regularly brushing, flossing, and paying attention to one’s diet.
The truth to the matter is that these dental fears did not just appear out of thin air. Refer to the complications section of this website to see many problems that can occur when extracting a wisdom tooth; however, this can be applied to other extractions and other dental procedures in some cases (although of course not any statistics presented).
When it comes to needles they can in rare cases contribute to permanently damaging a nerve via the anesthetic that is injected into that nerve. In even rarer cases, the needle can break off and require subsequent surgery to remove the fragment.
A drill can damage a plate, severe a nerve, and even leave a permanent lasting scar on the face. Like a needle, a drill bur (dental drill bit) can break off and require subsequent surgery to remove the fragment.
I have not seen any cases of someone choking on water and suffering injury during a dental procedure; however, the feeling of choking should not be taken lightly as a few have choked to their death on cotton rolls. http://www.teethremoval.com/dental_deaths.html
These negative events described are unlikely to occur but have happened in the past and certainly will happen again in the future. Even so, prevention is very important and a check up and dental prophylaxis should be regularly performed by a qualified dental professional.