dentist

Improving Value: Prespectives from Oral Surgeons

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An interesting editorial appears in the 2014, issue of the Journal of Oral and Maxillofacial Surgery titled “The Value of Improving Value,” by James Hupp (pp. 843-845, issue 72). In this Dr. Hupp presents a formula for patient value Value = A(Q + PS)/C A = appropriateness, Q = quality, PS = patient satisfaction, and C = costs The author states “First, one can improve outcomes while keeping costs the same. Second, one can decrease costs while keeping outcomes the same. Or third, both outcomes and costs increase, but outcomes per unit of cost improve.” In the article the author discusses how in the past, value in health care was really just about cost cutting. Clinical outcomes were not really taken into account. Now that health care outcomes are being considered, physicians need to find ways to measure value using the … Read more

When Should Children Start Using Fluoride Toothpaste?

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There is some conflicting information about when children should start using fluoride toothpaste. Studies have suggested that young children who consume large amounts of fluoride through fluoridated water, beverages, and toothpaste have an increased chance of developing mild enamel fluorosis see https://blog.teethremoval.com/large-amounts-of-fluoride-consumed-by-young-children-leads-to-fluorosis/. Hence some felt that not using any fluoridated toothpaste when a child was young was the better choice, whereas some felt that that using a small amount of fluoride toothpaste was okay In 2014, the ADA’s Council on Scientific Affairs updated its guidance on the use of fluoride toothpaste for children. The new guidance is that children’s teeth should be brushed with fluoride toothpaste as soon as the first tooth comes in. The idea is to provide children with the full benefit of cavity protection while also minimizing the risk of the development of fluorosis. The ADA’s Council on … Read more

Should You Have a Dental Extraction Before a Cardiac Surgery?

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An interesting article titled “Morbidity and Mortality Associated With Dental Extraction Before Cardiac Operation,” appears in the March 2014, journal The Annals of Thoracic Surgery (vol. 97, issue 3, pp. 838-844). The article is conducted by researchers from Mayo Clinic. They found that people who had planned dental extraction before cardiac operation are at risk for major adverse outcomes, which included a 3% risk of death before cardiac operation and included an 8% risk of a major adverse outcome including stroke or kidney failure. In many cases problem teeth are extracted before surgery with the thought being that they will reduce the risk of an infection occurring such as endocarditis which is an infection of the inner lining of the heart. Prosthetic heart valve-related endocarditis results in about 25% of infective endocarditis cases and is fatal in up to 38% … Read more

Few Children Under 1 See a Dentist

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Unfortunately, new research has shown that few children under the age of 1 are seeing a dentist. This was touched on in an earlier blog post over at https://blog.teethremoval.com/will-health-care-reform-result-in-more-dental-visits/ where it was mentioned that for children between ages 1 and 4 around 60% of them have seen a medical doctor (physician) during the year, but not a dentist. The new research appears in an article titled “Factors Associated With Dental Care Utilization in Early Childhood,” by Denise Darmawikarta and et al. which was published online in Pediatrics in May 2014. The study looked at 2505 children in Toronto, Canada, who were seen for primary health care between September 2011 and January 2013. The study was past of TARGet Kids (The Applied Research Group for Kids), a collaboration between doctors and researchers from St. Michael’s Hospital and the Hospital for Sick Children in … Read more

Will Health Care Reform Result in More Dental Visits

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An interesting article titled “Health care reform brings new opportunities,” appears in the April 2014 edition of JADA written by Marko Vujicic (vol. 145, no. 4, pp. 381-382). The article discusses how health care reform in the U.S., specifically the Affordable Care Act (ACA) may help bring about new opportunities for dentists. The article opens by discussing how the U.S. spends more money on health care than any other developed country and there is little measurable benefit in terms of health outcomes, patient satisfaction, and access to care. The author discusses how ACA is expected to bring access to dental care to an additional 8.7 million children by 2018. The author discusses how the focus is on implementing new health care delivery models and payment mechanisms that focus on value and not volume of care. The author believes that due to … Read more