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ADA Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net

Posted on 15. Aug, 2011 by .

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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.

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Wisdom Teeth Conspiracy: Electronic Eavesdropping Device

Posted on 07. Aug, 2011 by .

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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

There is also a website called antichips.com which providers further information on potential health risks of implantable microchips and also wethepeoplewillnotbechipped.com.

Source: James M. Mooney v. Veterans Administration, No. 90-1628, United States Court of Appeals for the First Circuit, December 3, 1990.

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ADA Straight From the Mouth

Posted on 07. Aug, 2011 by .

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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.

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The Hope, Inspiration, and Beauty of the World: Eat, Learn, Move

Posted on 05. Aug, 2011 by .

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In these times of economic stress and uncertainty due to the now latest S&P downgrade of the U.S. credit rating, let’s remember to see all that is good in the world and be happy and inspired.

Below are three amazing short times by Rick Mereki on behalf of STA Travel Australia.

We must lay hold of the fact that economic laws are not made by nature. They are made by human beings.

-Franklin D. Roosevelt

The people will save their government, if the government itself will allow them.

-Abraham Lincoln

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Why People Who Google and Search Online For Health Information Just Don’t Get It

Posted on 05. Aug, 2011 by .

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I find the current state of affairs on the internet to be extremely disappointing and discouraging. Recent research by the Pew Research Center’s Internet and American Life Project and the California HealthCare Foundation (CHCF)

“…found that 80% of Internet users look online for health information, making it the third most popular online pursuit among all those tracked by the Pew Internet Project, following email and using a search engine.”

The instance a person goes on the internet they are bombarded by conflict of interest after conflict of interest. Many young people today turn to Google to conduct searches to find information online (of course other search engines such as Bing exist).

The way search works of course is to enter some keyword or keywords you have in your mind about what you want to search for.  Well this is when things start to go astray. There is an entire field called search engine optimization (SEO) which is designed to bring websites to the top of the search keywords for those keywords people are most searching for and what topic the site is about or trying to sell. People will often click through the first few results to see if their questions or what they are searching for can be answered. This is where things really start to go astray. The questions you need to be asking yourself when conducting internet searchers is why is this particular site near the top of the search results and what is the motive of this site? All sites have some motive and are paid for by somebody to be up and running and have content.

Let me focus on the tremendous amount of conflict of interest now of various health websites with particular emphasis on this site teethremoval.com. Now the first conflict of interest to point out is that I run some advertisements on this site. Now I only make a very small amount of money from these advertisements and they do not influence my opinions and content on this site. However, you the user certainly does not appreciate advertisements. However, if you are like most internet users you may feel you have a sense of entitlement to be visiting websites on the internet and receiving information for free. Nothing in life is free! I could very easily switch this website off any at time and require you to pay to access the content. Any other website can do the same thing. Google and other search engines offer free search engines because it makes them money but they are not free there are advertisements on search engines. Once you get to a website you will often encounter advertisements. Even if there are no advertisements the content could still be paid for by someone, you got it!, as an advertisement. You need to keep in mind that everything you could be reading could just be one giant advertisement for something or for some agenda. Further, the site could have biased views based on who sponsors and pays for advertisements that you see on the site.

The next issue people run into when searching for health information is they think that if they read something they can understand it or sort of understand it enough to be able to benefit them in some way. You need to realize the tremendous amount of time and effort that has been involved over the years to learn about health related functions of the human body. This is no small task. You need to remember and keep in mind how grueling it is for someone to become a doctor and be able to practice medicine. This requires education all the way up to high school, then typically 4 years of an undergraduate degree, 4 years of a medical school degree, and additional years as an intern and resident. This requires tremendous amount of time, work, and investment and I assure you that the bulk of the information doctors are learning is not coming from internet websites.

On this website I have put together an elaborate and extensive list of complications that can occur as a result of wisdom teeth extractions. surfing the old school web Why People Who Google and Search Online For Health Information Just Dont Get ItWhen reading this list of complications and everything else on this site you have to keep in mind the motive of the site! I personally have an axe to grind and am also trying to generate additional revenue for my site through advertisements on this site. Hence one of my motives is financial and for me and most internet website owners the more traffic you have (as in more site visitors) then more money you likely generate. The other motive is I said I have an axe to grind. Now the story on my site is true, I did have all 4 wisdom teeth extracted upon the recommendation of my dentist, oral surgeon, and looked up wisdom teeth online at the time before the surgery by searching via Google a few websites that were near the top of the search results.  None of these parties ever told me that recently the Cochrane Collaboration had found that there is no scientific evidence to support preventative wisdom teeth extractions. Nor was I aware of the all the different types of complications people have suffered from extraction and that it was not standard medical practice to extract wisdom teeth in young healthy adults in the U.K. I thought I was following science that had been verified to best serve the general population and if I suffered some numbness if my nerve I could sue and receive some money as settlement. I was young and had just turned 20 so I did not know a whole lot about the medical industry and was extremely healthy. Certainly dentists and oral surgeons recommending and performing wisdom teeth extractions in young healthy patients in the past have genuinely thought it was in that patient’s best interest which may or may not be true for the aggregate and whole population. Hence I have an axe to grind since I feel I should have been provided more information prior to the surgery and financially compensated for my extremely painful 24/7 headache as a result of the wisdom teeth extractions.

Due to having an axe to grind, being motivated by financial incentives since I am stuck in a capitalistic society, and also being seriously injured and motivated to be healthy, I have to work hard towards making sure I stay on health insurance, can pay the bills, have a roof over my head, clothes, and food on the table.  This has resulted in an extensive review of scientific literature, newspaper articles from the past, legal cases, books, textbooks, and also of course internet searches to find other websites. Again let me make this clear I have looked extensively at scientific literature (journal articles), newspaper articles from the past, legal cases, books, textbooks, and also of course internet searches to find other websites. So my question to you is are you engaging in finding health information from other sources besides just what you find on internet websites? Do you even know how to?

I also have taken and completed extensive schooling and have a masters of science degree in biomedical engineering and a double major in economics and biomedical engineering for my bachelor of science degree. However, I do not currently have a PhD and do not currently have an MD.  I also have visited numerous doctors and have had discussions with them on many topics.

On this website, I  have for example constructed my wisdom teeth complications page in such a manner that I cherry pick case studies and wisdom teeth extraction accounts with a bad outcome. I also have listed many complications that are so rare they may have only occurred a handful of times. In addition, I do not list anything related to how experienced the oral surgeon or dentist is who is performing the extraction, I do not list where they went to school, if they were feeling well that particular day, what country the extractions occurred in, and a whole host of other potential factors that could have contributed to the bad outcome. Further, this page is a deliberate use of fear mongering designed to elicit a response although thankfully I try to not take it to the absolute extreme.

“While using fear in ads has generated some negative reactions by the public, there is evidence to show that ‘shockvertising’ is a highly effective persuasion technique, and over the last several years, advertisers have continued to increase their usage of fear in ads in what has been called a never-ending arms race in the advertising business.”

I personally do NOT like fear mongering, it’s purpose on my site is to help achieve my goals to promote scientific analysis applied to health, understanding that all humans have their flaws, no one can know anywhere close to everything, the quality of our healthcare systems can be improved, get people to think, and other things. The overwhelming majority of people who have wisdom teeth extracted do not appear to have any lasting complications. Yet on this particular complications page I only really list bad outcomes of the surgery. Hence these bad outcomes may be weighed in readers minds much more heavily.

I often read these days about patients who are finding health information online, printing it out, and bringing it with them when they see their doctor. If I was a physician and my patients did this I would be outraged! There are so many factors to consider when evaluating health information that it seems to me that the majority of people are not properly equipped to do so. What gives any one the right to print out something like 40 pages of something they read online about some medical condition and give it to their doctor.  Now certainly you have this right in some countries and can do so but your doctor will not have time to go through everything and fully evaluate all of the potential conflicts of interest. You would be better served to acquiring skills and talents you need if you would like to make sense of this information. This requires extremely hard work, long hours, lots of thinking, and likely taking out a large amount of loans for school if you are young.

At the end of the day those who do not have the necessary educational background may be better served not even turning on their computer. If you are trying to acquire some skills and abilities to better take control of your health you may be better served going to your local library, talking to your librarian, and reading books. Certainly the internet can be useful and helpful for some but it also has the power to be extremely destructive as well. At the end of the day I seriously question why people are using the internet to find health information. They would be much better suited to read medical journal articles, textbooks, books, and get a real education. Then they can do their own serious synthesis and analysis of the information, facts, and data.

Although it may not be clear I actually like dentists and doctors and have a lot of respect for them and what they do. However, everyone patients and doctors included need to understand that we are in this together. It can unfortunately be very difficult for physicians to stay in tune with all the new medical research that comes out every day. So yes doctors can learn from patients but more often than not patients are of course the ones learning from doctors. We are all human after all and all require sleeping, eating, and going to the bathroom. We all make mistakes and learn from them. We all strive for something. It’s time to be appreciative for all the hard work dentists and physicians do day in and day out. Unfortunately there are a few unethical ones out their without morals but generally people have good intentions.

So I have to ask you what are you doing looking for health information online and what do you hope to achieve? Why are you even on your computer? Did you ever stop to think that a more technologically advanced society that uses computers more and more may be inadvertently wiring their brains for the worst and destroying jobs for all the other hardworking individuals in society? Unfortunately simply just by me having this  website I may be adversely affecting other people’s lives.

Remember to be thankful for what you have and appreciative of all those other individuals who have created such a wealth of knowledge in this world. However, we need to use this for our advantages and not disadvantages.  Humans need to be forward looking and thinking long term for their species to survive and prosper. Enjoy the health you have today and celebrate and be thankful for being alive. Use your talents and skills to best serve your fellow man and woman.

Image from http://www.flickr.com/photos/homer_s/2237778477/ and has a Creative Commons Attribution 2.0 Generic License.

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