Fewer than half of Americans see a dentist each year and millions live in areas where access to dental care is severely limited, a new analysis from the health policy group Institute of Medicine (IOM) finds.

A severe shortage of dentists, especially those serving rural and minority groups, is contributing to the “persistent and systemic” barriers to oral health care, the report noted.

According to the report:

• 33 million Americans live in areas that are underserved by dental health professionals.
• 4.6 million children went without dental checkups in 2008 because their families could not afford them.
• In 2006, almost two-thirds of retirees (62%) did not have adequate dental coverage.

The IOM committee concluded that around 9,600 additional dentists would be needed to meet the needs of underserved populations in the United States.

“We have the lowest ratio of dentists to population that we have had in 100 years,” says Shelly Gehshan, who directs the Pew Children’s Dental Campaign. “This is a serious problem that leaves 40 to 50 million people out of reach of a dentist at any given moment.”

Dental Care Lacking for Children, Elderly, and Poor

Gehshan tells WebMD that millions of Americans lack dental coverage or the ability to pay for dental care.

She served on the IOM committee that issued the report.

Committee chairman Frederick P. Rivara, MD, tells WebMD that barriers to dental services disproportionately affect children, the elderly, and minorities.

Rivara is a professor of pediatrics at the University of Washington School of Medicine in Seattle.

“As the nation struggles to address the larger systemic issues of access to health care, we need to ensure that oral health is recognized as a basic component of overall health,” he says in a news release.

The IOM report included recommendations to federal and state policy makers to improve access to dental care.

Boosting Access to Dental Care

To address the shortage of dentists in underserved inner city and rural areas, the report calls for dental professional education programs aimed at increasing enrollment of African-Americans, Latinos, and people from rural areas into dental schools.

“Most dentists are white men,” Gehshan says. “Research shows that dental students from rural or underserved areas are more likely to go back to these areas to practice.”

The committee also called on the Health Resources and Services Administration to expand opportunities for dental residencies in underserved areas.

The IOM also addressed major limitations in oral care among economically disadvantaged people receiving Medicaid. States must provide dental benefits for children enrolled in the Children’s Health Insurance Program (CHIP), they are not required to provide benefits to adults.

Gehshan says while the committee members agreed that dental benefits should be available to all Medicaid recipients, the group recognized that this is not likely to happen in the current economic climate.

The committee called on federal officials to fund state-based “demonstration projects” aimed at providing dental care to adult Medicaid recipients.

In addition, the committee recommended increasing Medicaid and CHIP reimbursements and simplifying administrative practices.

“A growing number of dental professionals will not take people on these programs because reimbursements are just too low,” Rivara says.

The committee called on state officials to update their dental practice regulations with the goal of doing away with restrictions that limit access to dental services.

One example cited by Gehshan involved the application of fluoride sealants that help prevent cavities.

She says 22 states still require a dentist to examine a child before a dental hygienist is allowed to apply a sealant.

New Ways to Deliver Dental Care

Gehshan says innovative ways of delivering dental services will be needed to address the shortage of dentists.

The report called for more research into new approaches to care, including the use of mobile dental vans staffed by dental hygienists or practitioners who have several years of dental training but are not dentists.

Known as dental therapists, these practitioners are the oral health equivalent of nurse practitioners.

Only two states — Alaska and Minnesota — license dental therapists, but at least 50 other countries allow them to practice, Gehshan says.

The American Dental Association (ADA) has come out strongly against allowing non-dentists to perform surgery.

In a statement, ADA President Raymond F. Gist, DDS, praises the IOM report for highlighting the dental care access issue.

Gist notes that the ADA continues to support exploring new ways to expand access to dental care, but he adds, “We must, however, restate our opposition to allowing so-called ‘midlevel providers’ to diagnose disease or perform such surgical, irreversible procedures as extractions. Everyone deserves a dentist.”

Supplemental dental insurance is dental insurance that pays up to 50% of your dental care costs.

The idea behind supplemental dental insurance is that you already have some sort of dental insurance coverage in place. Supplemental dental insurance picks up the portion of your dental care that is not covered by your primary dental insurance. You must have primary dental insurance before you can purchase supplementary dental insurance coverage.

Individual Dental Needs

Each of us has different needs for dental care; some people need more expensive dental care than others. The reason for this disparity can be any one of a number of different factors. Patients who need more dental care than normal are good candidates for supplemental dental insurance

If a patient’s mother had certain vitamin deficiencies while she was pregnant with the patient, these deficiencies can manifest themselves as weakness or discoloration in the patient’s permanent adult teeth.

Other patients may have certain dental disorders because of inadequate nutrition while they were children, because they ate too much sugar as children, or because of excessive thumb-sucking as a child.

Some patients have a physiology that requires more dental treatment than would ordinarily have been necessary. Patients with big teeth and a small jaw will probably need to have one or more teeth extracted in preparation for the patient receiving orthodontic care.

Some patients have conditions at birth, such as a cleft palate, that requires ongoing dental and surgical treatment over the years.

Finally, some patients need supplemental dental insurance to repair damage done to their teeth due to neglect, dental malpractice, or drug use. Methamphetamine use, in particular, is devastating to the teeth, and patients who recover from methamphetamine addiction will need the kind of intensive, expensive dental care that is perfectly suited to supplemental dental insurance.

Choosing Supplemental Dental Insurance

When selecting supplemental dental insurance, ask some of the same questions as you would ask about ordinary dental insurance. Find out if you can choose your own dentist or if you have to select a dentist in a certain provider network.

Ask what kinds of services are covered by the plan. There is no sense in buying a supplemental dental insurance plan that does not cover the services you think you will need in the coming years.

Find out how the payment process works. Do you have to pay for dental services up front and seek reimbursement from the supplemental dental insurance provider, or will the provider make payments directly to the dentist?

Children can get extremely thrilled when they are allowed to consume as many fizzy drinks, chocolate bars and candies as they want.

However, as a parent you should make sure to limit the consumption of these harmful foods and beverages, if you want to keep the teeth of your child as healthy as possible.

Here are two important tips on how you can protect the oral health of your little one:

• When you are offering them fizzy drinks, make sure you teach them to use a straw. This way, the sugars from the drink will not have a chance to get in contract with the surface of the tooth.
• Protect the teeth of your child from decay, by offering them a chunk of cheese after meals. The cheese helps neutralizing the harmful acids from the mouth. Moreover, cheese helps making that enamel stronger and becoming a perfect barrier that will protect from tooth caries.

These 2 important tips are coming from leading health scientists in the field of oral health.

The sweet and fizzy drinks are extremely harmful for the health of the teeth of your little one, and if you teach them to use the straw, children will not be able to “swish” these carbonated drinks in the mouth and cause damage to the teeth.

According to several studies in the health field, the increased consumption of soft drinks and fruit juices has also led to an increase of the number of children struggling with tooth decay.

Today, around 2 in 3 children have got a severely damaged tooth by the age of five.

According to dental specialists, these soft drinks have a double damaging effect on the teeth:

• The acid that is found in the soft drinks damages first the natural barrier of the tooth, which is the enamel
• Then, when the sugars come in interaction with the teeth, these will also interact with the bacteria already “nested” there and a process of fermentation starts. This is how acid is born which is extremely harmful for oral health.

According to some further research in the field, children who consume on an everyday basis lemonade or cola have very damaged teeth, compared to the teeth of children who consume only natural fruit juices.

“Pediatric dentistry is incredibly important since habits children learn are most likely carried on for the rest of their lives,” said Dr. Robert Lerman, D.M.D., Southern Connecticut Dental Group. “That is why we see the importance of educating parents so that they can be informed and help their children form the best possible dental habits.  A healthy smile is important, and with proper care, a balanced diet and regular dental visits, your child’s teeth can be healthy and strong.”

• A toddler should never be left in the crib or for an extended period of time with any liquid other than water.  Milk or juice can cause bacteria and decay; baby bottle tooth decay, or early childhood caries.
• Run a clean damp washcloth after you feed your baby to prevent bacteria growth.
• Take your child to a pediatric dentist by the child’s first birthday or when the first teeth arrive, whichever comes first.
• As soon as your child’s first teeth appear, brush teeth with a little bit of water. After children have reached the age of 2, start introducing fluoride toothpaste in pea-sized amounts.
• Take care of your own oral health. Research shows that the bacteria that cause decay can be passed from caregivers to infants and young children. Rinsing with anti-bacterial mouthwashes has been shown to significantly reduce the number of cavity-causing bacteria.

WebMD Medical Reference

Reviewed By Brunilda Nazario, MD

Poor Oral Hygiene

Being under extreme stress may affect your mood and cause you to skip oral hygiene habits such as flossing and brushing.

If you don’t take care of your mouth, your teeth and overall oral health can suffer. If you already have gum disease, skipping daily hygiene may worsen the problem. If your mouth is in relatively good health, falling down on brushing and flossing can lead to gum disease or increase your risk of cavities.

When under stress, you may also develop unhealthy eating habits, such as snacking on large amounts of sugary foods or drinks. These habits increase the risk for tooth decay and other problems.

Just reminding yourself of the importance of hygiene and healthy eating may help. Boosting or resuming your exercise routine can help you relieve stress and feel energized enough to tend to your oral hygiene and cook healthier meals. Exercise will also boost your immune system — and that, too, is good for your oral health.
Gum Disease

Stress can cause an increase in dental plaque, even when the high stress levels are short term. That’s according to a study that evaluated people who cared for loved ones with dementia and who experienced stress.

Long-term, the stress these caregivers felt boosted their risk of bleeding gums, or gingivitis, which can progress to serious gum disease.

Stress can lead to depression. And depressed patients, according to recent research, have twice the risk of an unfavorable outcome from gum disease treatment compared to those who aren’t depressed.

You can’t make depression or the stress disappear, of course. But experts say that learning healthy coping strategies can help reduce the risk of gum problems getting worse. Healthy coping is “problem-focused” with active and practical strategies to deal with the stress and depression, experts say.

Remember, eating a balanced diet, seeing your dentist regularly, and good oral hygiene help reduce your risks of periodontal disease. Make sure you brush twice a day and floss daily.

Getting your teeth cleaned may give you more than a sparkling white smile — it may give you something to smile about, like your health.

In a large study, people who had their teeth professionally scaled at least once every two years were 24% less likely to have a heart attack, compared with those who skipped the hygienist. Scaling cleans between the gums and the teeth.

And their risk of stroke dropped by 13%, says study researcher Zu-Yin Chen, MD, a cardiology fellow at the Veterans General Hospital in Taipei, Taiwan.

“Something as simple as having good dental hygiene — brushing, flossing, and having regular cleanings — may be good for your heart and brain health,” says Ralph Sacco, MD, head of neurology at the University of Miami. Sacco, the immediate past president of the American Heart Association (AHA), was not involved with the work.

Although the link between dental health and heart and stroke risk is not entirely clear, inflammation is a common problem in gum disease and heart disease, Sacco tells WebMD.

A number of studies have linked chronic inflammation to hardening of the arteries, which can lead to heart attacks and stroke, he says.

Cleaning your teeth gets rid of bacteria in the mouth that can lead to chronic infection and inflammation, which can then spread to other parts of the body, Chen says.

The study was presented here at the American Heart Association annual meeting.

Benefits of Frequent Teeth Cleaning

Chen and colleagues reviewed the records of more than 100,000 people in Taiwan’s national health insurance database. About half had received at least one cleaning; the other half had never had a cleaning.

Their average age was 38 years. None had suffered a heart attack or stroke when the study began. They were followed for an average of seven years.

Results showed that people who had more than one cleaning a year had the lowest risk of heart attack and stroke, Chen tells WebMD.

Because the researchers didn’t have information on heart attack and stroke risk factors such as weight, smoking, and race — which could have affected the results — it could be that people with good dental hygiene are more likely to eat right and have other heart-healthy habits, Sacco says.

The cost of dentistry is what keeps more than half of consumers away from the dentist for years at a time, according to a survey by the American Dental Association. Most dental costs are easy to anticipate, though, except for emergencies, such as breaking a tooth. Less obvious dental needs often can be predicted by regular, routine checkups that include diagnostic x-rays to assess the overall condition of the teeth, gums and jaw.

Other needs to consider are whether you or a family member may require specialty care, such as braces or other orthodontia, dentures or tooth implants or crowns or bridges. These generally are not covered as extensively as routine care, such as exams and fillings.

Need Help?  Use our Genie Below to help you decide which plans are best for you!

Our “Dentist of the Month” will be answering questions straight from our Members. This month, Dr. Michael L. Curtis from Bridgeport, Connecticut has provided really helpful answers to some dental health questions. His office accepts over 15 discount dental plans and specializes in family, cosmetic and sedation dentistry.

Do Electric Toothbrushes Make A Difference?

Yes. Many people with arthritis, coordination disorders or other issues may find traditional tooth-brushing difficult. Studies show that patients using electric toothbrushes brush longer and remove more plaque on average. We also recommend a water jet to get in-between teeth under the gum and around crowns or bridges more thoroughly.

How Often Should I Have My Teeth Cleaned?

The time between cleanings can vary depending on your medical history, and dental or periodontal status. People with gingivitis and periodontal disease may need their teeth cleaned every 3 to 4 months. For healthy individuals, a cleaning once every 6 months is usually okay.

How Often Should I Brush, Floss & Rinse?

Most patients should cleanse their mouths before bedtime, so bacteria do not fester all night long while sleeping. Good oral hygiene upon wakening will help remove germs that buildup over night. A fluoride or antibacterial rinse can be helpful as well.

How Do You Foster A Dentist/Patient Relationship?

For every patient, we ask the question “If this were me or a member of my family, how would I like to be treated?” We truly value the quality of care we offer each patient-always delivered with the gentle touch, a friendly smile and a helping hand. You will never be rushed and we are never too busy to answer all your questions.

Why Do You Accept Discount Dental Plans?

Many wonderful patients have difficulty affording the highest quality of care. In this case, we are happy to reduce our fees just a bit so you can enjoy the finest treatment available. It’s our way of saying thank you after 30 wonderful years of serving thousands of families in our area.

Dr. Curtis graduated from the University of Pennsylvania where he received several awards. He then completed 2 years of residency training at Albert Einstein Medical Center in Philadelphia and Montifiore Hospital in New York. He is a member of the American Association of Cosmetic Dentistry, Academy of General Dentistry, American Dental Association and several other dental organizations. Dr Curtis has written 4 books on Dentistry and has served as an instructor at both the University of Connecticut and New York University Schools of Dentistry.

There are different types of orthodontic appliances; and, each one of them has pros and cons. I will focus on five of them here:

Self-Ligating Braces: These look just like normal braces. However, normal braces have ligatures that are used to hold the wire in place, while self-ligating braces are designed with built-in clips to make the wire.

Pros:

• They are very easy to clean, as there are no obstructions. This is because there are no ligatures, which are good at trapping food particles.
• Since there are no additions to the braces, they feel a lot more comfortable than other braces.
• There are less dentist appointments. This is because of the absence of ligatures, which require them to be adjusted often. This aspect ensures that the braces last longer than other braces.

Cons:

• They take time to completely suit your mouth, hence many adjustments during this period.
• They are not completely invisible.

Lingual Braces: These have metal brackets and wires designed to be fitted behind the teeth. They are ideal for people with moderate to overcrowding teeth, or for those with spaces between the teeth.

Pros:

• You can go on with your life without anyone ever noticing that you have braces, since they are fitted behind the teeth. They are only visible when you open your mouth too wide.

Cons:

• They are more expensive than other braces, as they are difficult to fit.
• Cleaning them can also be more difficult than cleaning other braces.

Metal Braces: These are the standard braces. They consist of steel wire and plastic ligatures. There are metal brackets that are used to clip the braces to the teeth.

Pros:

• These braces can be beautified with different colors to make them look more appealing.
• Though they are not cheap, they are the least expensive type of braces.

Cons:

• Metal braces can make it more difficult to floss and brush.

Invisalign: These are teeth trays made of clear, molded plastic. They are meant for both upper and lower teeth. These are fitted according to the tooth straightening stage you are in.

Pros:

• They are almost invisible when in use.

Cons:

• They are only ideal for people with minor straightening needs.

Ceramic / Tooth Colored Braces: Brackets are fitted on the teeth. They are usually tooth-colored.

Pros:

• They blend in well with the teeth.

Cons:

• The ligatured are made of latex, which stains. This makes them noticeable.

This article and the information within it was compiled by Jem. He often writes on issues related to gum disease, dentistry/orthodontics, nutrition and other oral hygiene/health topics. You can follow Jem on twitter @writerjem to learn more about topics he covers. 

Dental work can be very expensive–and unfortunately, many procedures are not covered by your medical insurance. It is very important to understand that prevention is the key to help save and reduce the costs incurred from dental work. This article will help give you tips on how to save money on dental health.

Maintain the health of your teeth and your mouth, since poor dental hygiene will increase the risk of getting ill and predisposes you to many other medical conditions. Brushing, cleaning and flossing several times a day will help keep your pearly whites and your mouth in optimum condition. This will reduce the number of dental visits and reduce the cost of dental work in the long run.

Refer family, friends or colleagues. Some dental offices offer reduced prices or free cleanings to those who refer patients to them.

Better yet, Choose from more than 86,000* available dental practices locations nationwide, through one of the country’s largest dental discount networks – the Aetna Dental Access® Network.  Click the Aetna logo above to start saving thousands on your dental needs for only $9/month.