Guest opinion/Grand County " Article on dental care barely brushed the surface | SkyHiNews.com

Guest opinion/Grand County " Article on dental care barely brushed the surface

David Lurye, DDS
Winter Park

I read with interest the article written by Jen Giacomini in the Feb. 26 Sky-Hi Daily News. The article makes an attempt to state the importance of oral health in children but is factually flawed on several fronts. It omits important information for prevention of dental disease and does not delve into more of the reasons that so many children (and for that matter adults) do not see a dentist regularly.

The author tackles prevention of tooth decay and leaves out one of the most important aspect of prevention, which is either municipal water fluoridation or consumption of prescription fluoride tablets. The ingestion of fluoride is critical while the primary (baby) teeth and adult teeth are forming, which is between six months and 16 years. That’s tap-water from a fluoridated municipality, which we have few of here due to the fractured status of the many water districts.

The fad of drinking bottled water like it is some magic elixir is beyond me, but it usually will have no fluoride, and the consumer can expect to be out at least as much as they would spend on dentistry just to buy their favorite brand. By the way, I doubt that anyone out there has “insurance” to pay for their bottled water … but it gets purchased just the same. More on that later.

This link http://www.ada.org/public/topics/fluoride/fluoride_article01.asp#systemic is useful in finding out more about systemic fluoride use.

The other mode of application of fluoride is topically, which can be done at home with a variety of toothpastes and/or prescription strength gels, depending on the risk status of the individual. Even higher levels of fluoride can be applied by dental personnel, usually in conjunction with having the teeth cleaned. The American Dental Association Web site http://www.ada.org is a link to a collection of scientifically gathered data regarding fluoride .

The article touches on dental sealants and totally drops the ball on the fee associated with them, when they should be placed, or the high effectiveness of them. Third grade is too late. They need to be placed when the permanent first molars erupt, which is typically at age six. They should usually be placed on 12 year molars as well, and are often placed on bicuspids and some front teeth when the anatomy of the teeth include deep pits or fissures. They are virtually 100 percent effective when fully retained, and overall decrease decay levels about 70 percent in a general population. The following is a good Web site to visit for more info:

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http://www.cdphe.state.co.us/pp/oralhealth/dentalsealants/DentalSealantsinPreventionofToothDecay.pdf

By the way, a typical fee is in the $45 to $55 dollar range, not $75 as stated in the article.

In my 20 years in Grand County we have seen many children get all the way through college without ever having developed a cavity just by brushing well, flossing, having sealants placed, having as sensible a diet as a teenager can have (yikes), and having optimum fluoride both topically and in their water or in tablet form.

The economics of this endeavor is a touchy subject. I have been practicing in this county since 1988, and the apparent brainwashing of the public into the belief that they need dental “insurance” is beyond me.

I see people bring in children with severely decayed teeth due to lack of regular care in a dental office, yet these same parents have managed to buy snowmobiles, taken trips to tropical islands, and somehow managed to pull into our parking lot in brand new SUVs.

They tell me that they have not brought in their kids (or themselves) because they had no insurance. Well, insurance didn’t buy their snowmobiles, their trips or their SUVs either. Perhaps they ran out of money buying that de-fluoridated bottled water.

I have literally had mothers tell me while standing in Safeway that they cannot afford to bring themselves or their kids in, all the while clutching their double latte from Starbucks. Makes me want to scream.

There are the genuinely impoverished and disadvantaged, and then there are those that spend their disposable income on things more fun than going to the dentist.

There is the rub, as Shakespeare would say.

How do we separate them? Who is responsible? Who should pay for their care?

Should we raise taxes to provide free or reduced health care for all, or should it be subsidized by the state or federal government? This is a burning issue, because no one wants higher taxes, but apparently there are many that feel that medicine and dentistry should be provided with someone else’s money.

Our office is like tens of thousands around the country that try to give free care to those that we perceive are most in need, or at least reduce fees for as many of them as we can afford to. Some state programs help separate these categories by doing income screening, like CHP and Medicaid. That is helpful, but then again Colorado is 47th or 48th as far as reimbursement in the nation for Medicaid payments for dentistry, and the system is extremely user un-friendly.

Our CHP program is held hostage by a private company, Delta of Colorado, that insists on dentists joining their other programs in order to participate in CHP, a federal and state funded program. I repeat, a private company is restricting a federally and state-funded program by demanding that dentists join their other networks. This is not their money. It is yours and my money.

Seems pretty darn unethical to me, and you would think a state or federal politician or two would step up to the plate and fix that, but apparently they are more concerned with baseball players taking HGH or steroids than concentrating on problems concerning our less famous and infinitely less well-to-do population.

Our Grand County Public Health Department is beginning to chip away at the problem, but they cannot fix it overnight. Nor can the few dental offices in our county. I have not until Miss Giacomini’s article ever seen an article actually suggest that the consumer, the patient, the customer actually BUDGET money for their health care. I applaud her for doing so.

Recently, and very sadly I lost my beloved dog in a sudden turn of events while at the animal ER in Denver. There was a couple in front of me paying their bill, and I watched as they put it on two credit cards. There were no words lamenting the fact that a $3,000 bill at the vet would not be covered by insurance. They were trying to help their animal. Should not this same level of concern be given to our children?

I implore anyone out there with children to do a few things:

– Budget in health care just as the article suggested.

– Contact a dentist of your choosing and ask if payment arrangements or special health-care credit cards are available.

– Contact your state legislators, including the governor’s office, and implore them to change some of their rules and regulations so that publicly funded programs like CHP are made available in the county.

– Help your children brush and floss until at least age 8. Good intentions by them are no match for less than adequate dexterity or boredom with the task.

– Use a fluoride containing toothpaste. Limit the amount of sweets, carbonated beverages and sport drinks, and cut down on the frequency of them, as every time they are consumed, bacteria are secreting acid that eats into the teeth, raising the possibility of decay.

– And for goodness sake, if your child is involved in sports, have them wear a mouthguard. Lots of nice, clean fluoride coated teeth are chipped , loosened or knocked out by accidents.

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