The NobleDentist Blog

This article is a result of a survey conducted by Guardian on the American people.

89% of Americans make the connection that their overall health is linked to their dental hygiene according to a consumer dental survey, entitled Benefits and Behavior: Spotlight on Dental, released by The Guardian Life Insurance Company of America (Guardian). The study shows that Americans tend to see their dentists regularly and reveals oral health differences along gender and generational lines.

Benefits and Behavior

Seven in ten adult consumers report making a visit to the dentist at least annually, with a surprising 47% of consumers saying they visit the dentist every six months. Women visit dentists more frequently than men. (73%) of the women compared to (66%) of the men surveyed visit the dentist on a regular (once a year or more often) basis.

Lack of coverage is the foremost reason why those without dental coverage limit their visits to the dentist. Among consumers without coverage, 73% said they don’t visit the dentist regularly because they are without coverage.

Ms. Manners, Meet Mr. Hygiene

According to the Guardian survey, roughly 40% of men either brush or floss at work and an equal percentage of women say it’s impolite to do either. Men are more inclined to freshen up on the job than are women: 31% of men brush and 30% floss at work, while 26% of women brush and only 22% floss at work.

Tooth-full Optimism: Retirees with Teeth

More than half of those surveyed believe they will have all or most of their teeth at age 70, dropping to 41% at age 80 and 31% at age 90. Older Americans are far more optimistic about keeping their teeth in their retirement years than younger adults.

81% of younger Americans (age 18-34) expect to have lost at least one tooth by age 80 compared to 68% (age 35-44), 71% (age 45-54), 72% (age 55-64), and 67% of adults age 65+.

“Some things get better with age, but our teeth are not on the list,” said Foley. “But Boomers are appropriately optimistic. Due to advances in dentistry such as dental implants, fluoride and sealants, Boomers will usher in an age where retirees can expect to have all or most of their teeth throughout their retirement.”

Tooth Replacement: Vanity or Necessity?

When asked about tooth replacement, most (66%) Americans say they consider it a medical necessity, not a cosmetic procedure. Women (70%) were more likely to consider tooth replacement “medically necessary” compared to 61% of men.

“Dental implants are widely accepted by the dental profession as one of the most effective procedures for the replacement of missing teeth,” said Richard Goren, DDS, second vice president, Group Dental, Guardian.

The Guardian survey represents the findings of a telephone survey conducted among a national sample of 1,023 adults comprising 508 men and 515 women, 18 years of age and older, living in private households in the continental United States. Interviewing for this survey was completed during the period September 21 – 24, 2006.

This is an article by Sherri Green that appeared recently in The Houston Chronicle.

Hershel Rich survived three bouts of lymphoma. Between them he underwent blood and bone marrow tests, colonoscopies and CT scans to detect recurrences.

“I must have been a pin cushion at least 700 or 800 times,” Rich said. “It’s no fun.”

The retired businessman took heart when he heard about a Houston dentist attempting to develop tests to diagnose breast cancer through simple, painless saliva tests.

Researchers are just beginning to unlock the slimy secrets of spit, but in it they are finding most of the things doctors look for in blood and urine.

“Saliva has lots and lots of proteins and peptides we can measure that are very similar to (blood),” said Dr. Mythily Srinivasan, an assistant professor of oral pathology at the Indiana University School of Dentistry.

Here in Houston, Dr. Charles Streckfus foresees the day when women will be screened for breast cancer every time they have their teeth cleaned.

He came to the University of Texas Dental Branch last year with four refrigerators full of saliva samples taken from women suspected of having the disease.

A cocktail of fluids

Glands in the mouth produce three pints of saliva daily. Mixed with substances from the bloodstream and the gastric and respiratory tracts, spit becomes a cocktail of bodily fluids. It contains proteins, hormones, viruses and billions of bacteria that can be used to detect everything from cystic fibrosis to AIDs. While tests to detect many diseases still are under development, kits already can be purchased to test saliva for illegal drug use.

“The protein expressions in saliva look like fingerprints for diagnosing these things,” Srinivasan said. “Saliva almost mirrors what is in the blood.”

Streckfus was at Johns Hopkins University when he began searching for an alternative to mammography for breast cancer screening. “When a woman receives a bilateral mastectomy, there is no way of monitoring her health,” he explained.

Later, Streckfus spent a decade at the University of Mississippi collecting wads of tasteless chewing gum spat out by women being assessed for breast cancer. By looking for certain protein biomarkers in saliva, his team identified which patients had malignancies 85 percent of the time. But those early tests proved nonspecific — sometimes the cancer affected the ovaries, lungs or gastrointestinal tract instead of the breast.

Streckfus came to Houston last year to be closer to UT’s M.D. Anderson Cancer Center and to gain access to the university’s mass spectrometer. It has accelerated the study of proteins in much the same way it has advanced genetic research.

“We can go down to a level with proteins that nobody knew existed,” Streckfus said, noting that his Mississippi team documented about 60 biomarkers in saliva. “Now, we have discovered more than 200 proteins we don’t know the function of.”

Other ailments targeted

Along with oncology researchers at UT Medical School, Streckfus is working to patent a “diagnostic tree” that would detect breast cancer and other specific malignancies based on proteins in saliva.

Early next year, Streckfus hopes to begin collecting samples from a broader population of women seen at the UT Dental Branch, not just patients already suspected of having cancer.

Rich, 81, had just been diagnosed with lymphoma for the fourth time when he learned about Streckfus’ work.

“I decided I’d call Dr. Streckfus to see if he would like to take some of my saliva and find a marker for lymphoma,” Rich said. “If you could diagnose lymphoma from saliva it would be much less painful and far less expensive than going through all these other tests.”

Rich donated a spit sample before beginning chemotherapy and will repeat the process during and after treatment while Streckfus searches for biomarkers.

Meanwhile, Srinivasan in Indiana is studying a spit protein linked to colitis and a certain type of mouth ulcers. “I think we will probably get a kit that will eventually diagnose colitis via saliva, and some cancers,” she said.

Dr. Streckfus said he hopes simple breast cancer screenings will be available in dentists’ and doctors’ offices within 10 years.

He stressed, however, that spit tests won’t replace mammograms, which pinpoint malignancies.

This is an article that appeared recently in the ABC News Online.

The Federal Opposition’s deputy leader, Julia Gillard, says more funding and more dentists are the key to ending the crisis in dental health.

Ms Gillard has spent time this morning at a dental surgery at Tweed Heads, in northern New South Wales, speaking to patients and staff.

Her visit is part of a national Labor leadership tour to raise the new leaders’ profiles and promote their new frontbench team.

Ms Gillard says there are 65,000 Australians on dental waiting lists.

“When you raise this issue with the Howard Government they blame state governments,” she said.

“State governments rightly say, ‘well the Howard Government took money out of dental care and doesn’t train enough dentists’,” she said.

“It’s a classic example of the blame game and it’s a classic example of where people are being hurt.”

Labor’s new spokesman on federal-state relations, Bob McMullan, says there are problems with duplication between the states and Commonwealth in health, as well as aged care and other key areas.

Mr McMullan’s portfolio has been created in a shake-up of Labor’s frontbench, and will focus on the Opposition’s federalism reform program.

Mr McMullan says he will focus on cooperating with the states, but has made it clear both levels of government will need to address the issues raised.

“If there’s an aged person who should be in an aged person’s home, in a hospital, well that means the State Government pays for their accommodation. Whereas if they are in a nursing home, the Commonwealth would pay,” he said.

“So the Commonwealth actually has an incentive not to provide that person with an aged person’s bed, because they can shift the cost across to the State Government while they’re in the hospital.”

This is an article that appeared recently in the ABC News Online.

Prime Minister John Howard says he will look at a House of Representatives Committee report on Australia’s health system.

The report calls for a national approach to health, with an overhaul of the way the Commonwealth funds public hospitals.

The committee has also suggested the Federal Government give more to public dental services.

But Mr Howard says the Commonwealth is contributing, with hundreds of millions of dollars injected into Medicare.

“As far as dental services are concerned, the Commonwealth contributes some 30 per cent rebates for private health insurance,” he said.

“We’ve increased the rebates for older people but … the states are responsible for the dental care of their communities and it’s about time they carried out their responsibilities.”

This is an article that appeared recently in the ABC News Online.

A House of Representatives committee has called for a national health agenda and an end to the blame game between the states and the Commonwealth.

A Standing Committee on Health and Ageing report says a national approach is needed to overcome problems in health funding and administration.

The report says there is a need for the roles and responsibilities of each level of government to be clarified.

Several of the committee’s recommendations call for an overhaul of the Commonwealth’s funding agreement for public hospitals.

Other recommendations include a call for Australia to develop a plan to train all its own health professionals by 2021 and for the Commonwealth to give more to the states for public dental services.

This is an article by Sarah Williams that was published recently in the Monterey Herald.

From the outside, it looks like a camping trailer. Or a lunch truck. Inside, colorful posters cover the walls, a radio plays softly, fuzzy fish hang from the ceiling and three kids wait in line for a turn in one of two dentist chairs.

“We see a lot of patients even though we’re so small,” said Doreen Briseño, the head dental assistant for the 40-foot-long mobile dentist unit that has traveled around Monterey County since 1998.

As she spoke of how busy the cramped office gets, Briseño flossed a girl’s teeth and pointed out an X-ray machine.

Across the trailer, on the other side of a thin curtain, Dr. Aarti Shah leaned over another girl’s mouth, inspecting her teeth for cavities, the biggest dental problem facing the low-income children that the mobile unit serves.

“This morning I saw a young boy who had 16 teeth with cavities,” said Shah. “But his mom didn’t have the money to take him anywhere.”

The case that morning was no rarity. Shah said many low-income parents in the county do not realize the importance of dental health, or cannot afford it.

“Parents are not aware that they need to brush their kids’ teeth even when they’re babies,” she said.

Parents who let their infants sleep with a bottle are unaware that milk will cause cavities as it sits in the babies’ mouths all night, said Shah. And they do not usually know that because cavities are caused by bacteria, a mother’s bad dental care can cause cavities in infants.

Beyond a lack of dental knowledge, is the shortage of local dentists who treat low-income children. Most pediatric dentists don’t accept Denti-Cal, the dental portion of the MediCal health coverage program.

The mobile dentist fills this gap. Since 1998, Community Oral Health Services, a Salinas nonprofit group, has operated the traveling office they affectionately call “Smiles on Wheels.”

The trailer rotates among Salinas, Marina del Mar and Seaside, spending a week or two at each location. It accepts Denti-Cal insurance and have flexible payment schemes for those with no insurance. Staff members are bilingual, because more than 85 percent of their patients are Latino.

A larger, 60-foot dental unit spends time in Soledad, Gonzalez, Greenfield, King City, San Lucas, San Ardo and Bradley, moving every few months.

Last summer, the foundation received a $500,000 grant for a third mobile unit, which will be operating by May.

Debi Diaz, the director of Community Oral Health Services, said the goal of its staff is to treat children with teeth problems, and to prevent problems in the first place, through education.

As a result, they try to limit the small mobile unit to 15 patients per day, so they do not feel rushed.

“We want to spend quality time with the families on prevention education,” said Diaz.

Shah echoed this sentiment, saying personal contact with the children is important.

“Many dentists don’t want to take kids,” she said. “You need to talk to them and that takes time. Some people don’t want to waste time on kids.”

But Shah finds working with children rewarding.

“These kids are so little,” she said. “I, personally, don’t want them to suffer. They go to school but they cannot concentrate when their teeth hurt.”

To prevent such extremes, Community Oral Health Services holds workshops for teachers and parents to emphasize that dental care should start at infancy.

“Even though baby teeth will fall out, they need to be taken care of because they reserve space for the adult teeth that will grow in,” said Shah.

As each patient leaves the clinic, staff members help them fill out a contact card so they can be reminded when they need another appointment, and when the trailer will be in their area.

Darien DeLorenzo, the executive director of Mobile Health Clinics Network, says communities all over are starting to realize the benefits of mobile health units.

DeLorenzo is building a database of all the mobile programs in the county. Her list has 3,000 entries. She said California led the upward trend she has seen during the past five years.

“In my experience, California seems to be in the forefront of mobile health care,” said DeLorenzo.

For the clinic’s staff, each smiling patient is what gives the statistics meaning.

“There are so many kids that need treatment and they wouldn’t know where to go if we weren’t here,” said Shah. “It feels like I’m doing something for the community when I work here. It feels good.”