J. Peter St. Clair, DMD Blog

This is a phrase we hear far too frequently when patients call to cancel or change their dental hygiene appointments. When the patient is told that there are no open hygiene appointments for 4-6 months, the response is often, “Oh, that’s okay, it’s just a cleaning.” This lack of concern is only partly to blame on the patient; most of the accountability falls in the lap of the dental team.

If you read this column with any frequency, I am sure you have seen me report that 75% of the population has some form of periodontal (gum) disease. I’m sure you have also read that periodontal disease has been linked to heart disease, stroke, pre-term, low birth-weight babies, diabetes, and possibly even some types of cancer. The problem is the dental team is not discussing this enough with their patients.

Here’s the way I see it: If a patient has made the decision to seek the services of a dental office, we must assume that the reason is based on wanting to improve and/or maintain their dental health. If that’s not the reason you go to the dentist, what is? Patients will often say during an exam, “Please don’t find anything.” Our response may be, “Well then, I better not look.” Assuming the reason for going to a dental office is to improve and/or maintain dental health as part of overall health, it is the obligation of the dental team to “find stuff” if it’s there, communicate that with the patient, and have a conversation about whether any steps should be taken.

For example, based on your level of periodontal health, there are different levels of frequency recommended for hygiene visits. The majority of patients should be seen every 6 months. Some are lucky enough to have yearly visits recommended to them. For others, every 3 or 4 months is recommended. This frequency is determined by your dental team to maintain your dental health. Regardless, if you put off your routine care by 1, 2 or even 6 months, that is a lot of time to have bacterial growth accumulate and put your body into a defensive mode due to increased inflammation. This brings me back to the reason you have chosen to be an active dental patient.

Remember, gum disease is not only bad because it makes your breath stink and your teeth fall out; it is bad for you systemically because of chronic inflammation. You may very well not notice an increase in inflammation, but your body does. There are measurable indicators of this.

If your goal is optimal health, routine maintenance is essential. I tell my team all the time that we must continue to educate the people who put their trust in us to maintain their dental health.

Depending on your car, there is a recommended maintenance schedule. If you ignore the recommended maintenance, only bad things can happen. You may be able to “stretch it out” a little, but must understand there are risks associated with that decision. If you knew how bad chronic inflammation really was for you, you would want to be seen more frequently than you are.

There are obviously valid reasons why patients need to change an appointment. Most dental offices understand that. It is the frequency, attitude (It’s just a cleaning), and lack of commitment that causes both disruption within the dental office and discontinuity of care.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

If you missed Part 1 and/or 2 of this series, you can find it at www.thetowncommon.com.

The past couple weeks have been about the growing evidence that links oral and systemic disease, and the need for more collaboration between dentists and physicians. All of this, of course, is in the best interest of the patient.

The body is a complex system – and everything is connected. The health status of an individual’s mouth can absolutely play a role in systemic health or disease.  In addition to the need for dentists and MD’s to collaborate more on the oral/systemic connection, we also need to collaborate better about our patient’s sleep problems. 

As part of a comprehensive approach to care, we screen for sleep issues with our patients. It amazes me how many people have issues with their sleep. It amazes me even more when I learn that many of these people have never even had a conversation with their doctor about sleep. Experts in sleep medicine agree that there is much room for improvement in this vital part of our health care.

Periodontal issues and sleep are just two areas where more information should be shared between dentists and physicians. We have to be open to the fact that everything is connected, and needs to be taken into consideration when we are trying to diagnose, monitor, or solve our patient’s problems.

I recently saw someone who has been a patient of mine for about 7 years. I noticed in the patient’s notes that bruxism/grinding had been discussed at most hygiene appointments in the past, due to the noticeable wear patterns on the patient’s teeth. There was also a note in the chart several times stating that the patient would never wear a dental appliance at night.

As I did my exam, I kept thinking to myself that there must be more to the story behind this patient’s dental issues. It happened to be around our lunch break, so I asked the patient if she had a few minutes for us to talk. She seemed interested in what I had to say. I photographed her teeth to compare them with photos taken 7 years ago. We talked for an hour.

Aside from learning that the patient was on (7) medications for the past SEVEN years and had never reported any of them to us, I also learned that the reason she was also resistant to wearing something to protect her teeth at night was because she had sleep issues. She felt there was no way she could handle the extra stuff in her mouth. I also learned that both of her parents are treated for sleep apnea.

So, here are some bullet highlights from the past 3 weeks:

1. Periodontal (gum) disease is bad. Just because it doesn’t hurt doesn’t mean you don’t have a problem. If you care about your general health, you must take care of your mouth.
2. Delaying care of dental problems always leads to more treatment and more cost.
3. Don’t leave information out when discussing your health with your doctors. Everything is important.
4. For better patient care, doctors and dentists should have more collaboration.
5. Time is the most precious gift a health care provider can give their patients.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

If you missed Part 1 of this series, you can find it at www.thetowncommon.com.

I ended last week with a statement that I have used numerous times before – just because it doesn’t hurt doesn’t mean there isn’t a problem. We keep learning more and more about the link between the mouth and the rest of the body. It is essential that dentists and physicians do a better job at co-managing patients, and learn more about the relationship between oral and systemic disease.

And if we’re being completely honest, there also needs to be a disruption in the insurance industry. Dr. Robin Davies (Byfield) said recently, “It just seems like common sense to me. If you had a chronic infection on your arm, wouldn’t you think it would affect your whole body? Why is it that the mouth is treated like it isn’t connected to everything else? A downfall of our healthcare system, for sure.”

It is clear, if you want to take better care of yourself, you need to take better care of your mouth. Familial history is very important. If you know of any family history of dental problems, you are at higher risk. Higher risk individuals need to be treated differently, and may need a more aggressive preventive protocol to help ward off progression of disease. In addition, an otherwise healthy person who presents with a sudden increase in gum inflammation should possibly be evaluated by their physician to rule out any systemic causes if there is not a simple explanation for the change.

Salivary biomarkers are among the tools being researched to help determine the particular disease path that a person is on. Although in their infancy, this precision approach to the prevention and treatment of periodontal disease accounts for variability in a person’s genes, environment, and lifestyle. Because it is more personalized to the individual, it results in more accurate treatment planning, as well as improved outcomes for the patient.

Considering the aging population, periodontal (gum) disease has the potential to become the most prevalent dental disease in the near future. It is more important than ever for dentists to take the time to develop and incorporate a comprehensive periodontal examination and treatment protocol for adults…..and to educate our patients on the importance and connection with rest of our bodies. 

As with most diseases, delaying the treatment of periodontal disease until the advanced stages results in treatment that is more expensive, more complex, and less predictable. Most early to moderate stage disease can be treated in a general dental office if the inflammation is easy to control, the patient doesn’t have numerous systemic issues, and is determined to do their part at home. If all these things have been done without resolution, or if the periodontal disease is more severe, it may be in the patient’s best interest to be referred to a like-minded periodontist. A periodontist is a specialist who treats disease of the gums and bone that support the teeth.

When half of the US population is still affected with periodontal disease, despite decades of research and treatments, something is still missing. That missing key is a more collaborative approach involving, dentists, periodontists and physicians.

….and remember, just because it doesn’t hurt doesn’t mean there isn’t a problem. To be continued.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

The connection between oral health and systemic health is well-established and ever-evolving. One thing we know for certain; we are living longer, but with more chronic diseases and medication than ever before.

The latest statistics are alarming. Forty-seven percent of US adults who are age 30 or older – an estimated 64.7 million Americans – have either mild gum disease (8.7%), moderate gum disease (30%) or severe gum disease (8.5%). As the population ages, the prevalence rises with 70% of individuals over the age of 65 exhibiting some level of gum disease. And, since we are on statistics, by 2030, it is estimated that the number of people over 70 years of age will have doubled from 35 million to 71 million.

As we age, our risk of developing disease increases. Interestingly, there is also a direct correlation between the regions of the US with the greatest concentration of gum disease, and those that have a high incidence of cardiovascular disease and diabetes. Although a direct cause-and-effect link is still in the process of being established between gum disease (periodontitis) and other systemic diseases, inflammation is often a common denominator. And it is always important to remember that the mouth is the gateway to the rest of the body.

We used to think that if people didn’t brush their teeth well, or didn’t visit a dentist often, they would automatically get gum disease. However, there are patients who have poor home care who never develop gum disease, and there are also patients who have great home care, visit a dentist regularly, and continue to experience breakdown from gum disease – albeit at a slower rate than they would if they had poor habits.

We now know that managing gum disease and other chronic inflammatory diseases like cardiovascular disease, diabetes, respiratory disease and arthritis are more patient specific based on an individual’s “inflammatory mediators”. These are molecules released by immune cells and are largely responsible for individual responses to disease susceptibility and progression. This is why probiotics are likely to play a significant role in treatment of chronic inflammation in the future.

As we wait for research development for different ways to combat chronic inflammation, it is without dispute that people should do all they can to minimize inflammation in the mouth. The mouth is very accessible and with proper training, coaching and monitoring, a healthy mouth is better for your whole body.

Although some may say that the associations between gum and systemic diseases are statistical by nature, not causal, the data is fairly strong that there is a link between gum disease and cardiovascular disease – such as heart infarction and stroke.  This supports diagnosing and treating oral infections, including lifelong professional maintenance and good home care.

Just because it doesn’t hurt doesn’t mean there isn’t a problem. More next week.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

I think it is safe to say that our healthcare system has some flaws. Wouldn’t it be nice to have a healthcare system that realized that everything in the body is connected? Unfortunately, there are no reasonable solutions for this in the near future. Therefore, it is important for you to take your health into your own hands and plan appropriately.

Patients will sometimes balk at treatment not covered by their dental insurance. Dentists will often hear, “Just do what my insurance covers. I don’t want anything extra.” In fact, a recent ADA poll showed that a lack of dental insurance was the #1 reason most patients gave for not visiting a dentist. Here are some frequent questions patients often ask about dental insurance.

Why doesn’t my insurance cover all of the costs for my dental treatment?

Dental insurance isn’t really insurance (defined as a payment to cover the cost of a loss) at all. It is a monetary benefit, typically provided by an employer, to help their employees pay for routine dental treatment. “Dental Insurance” is only designed to cover a portion of the total cost.

But my plan says that my exams and other procedures are covered at 100%.

That 100 percent is usually what the insurance carrier allows as payment towards a procedure, not what your dentist may actually charge. Dentist’s fees are usually a reflection of the level and quality of care in a particular office. Some cost more, some cost less, depending on the costs of running their office, how much they pay their staff, the materials they use, etc. An employer usually selects a plan with a list of payments that corresponds to its desired premium cost per month. Therefore, there usually will be a portion not covered by your benefit plan.

If I always have to pay out-of-pocket, what good is my insurance?

Look at medical insurance. Many people have been forced into high deductible plans ($2000 or more). Most dental plan deductibles are $50. While dental insurance is far from ideal, any amount that reduces your out-of-pocket expense helps.

Why is there an annual maximum on what my plan will pay?

Although most maximum amounts have not changed in 30+ years, a maximum limit is your insurance carrier’s way of controlling payments. Dental plans are different from medical plans, in that dentistry is needed frequently. Medical emergencies are rare. It is your dentist’s responsibility to recommend treatment based on diagnosis and treatment planning of what is appropriate for your dental health, not necessarily what your dental plan covers.

If my insurance won’t pay for this treatment, why should I have it done?

It is a mistake to let your benefits be your sole consideration when you make decisions about dental treatment. People who have lost their teeth often say that they would pay any amount of money to get them back. Your smile, facial attractiveness, ability to chew and enjoy food, and general sense of well-being are dependent on your teeth.

Other than complaining to your dental insurance company or your Employee Benefits Coordinator, your best defense is to budget for dental care. First, find a provider based on a personal fit for you. That is the single most important thing you can do.  If that office can’t work with you financially then I would find another office.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Last week was teenager sleep patterns and issues. This week we start a conversation about how our sleep needs and potential issues as adults.

We all do better when we get good quality sleep. For some people though, sleep quality is consistently poor. There are many folks out there who “get by”, but are not functioning at full capacity due to poor sleep. Many of them think they sleep fine, but they don’t.

Insomnia, difficulty with falling asleep or staying asleep for more than 3 nights a week, is the most common sleep disorder. Sleep “hygiene” improvement, along with cognitive behavior therapy, is the first course of action to treat this problem.

There are many reasons for poor quality sleep. Some are easier to control than others.  Everything from a poor mattress, poor pillow, sleep position, medical issues, diet, alcohol consumption, and work schedule can have an impact on the quality of sleep that we get. Although some people can notice subtle changes in sleep quality, many others do not realize that some of the issues they have routinely can be caused from poor sleep quality.

Sleep plays a vital role in good health and well-being throughout our lives. The way you feel while you’re awake depends in part on what happens while you’re sleeping.

Sleep helps your brain work properly. Studies show that a good night’s sleep improves learning. Studies also show that sleep deficiency may cause you to have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change.

Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, stroke, sexual dysfunction, ADHD, obesity and depression.

Sleep issues can affect the young, the old and everyone in between. The many changes that take place in our bodies as we age can increase the risk of sleep disorders.

Sleep apnea is another common sleep disorder. It is a serious, potentially life-threatening sleep disorder that affects approximately 18 million Americans. It comes from the Greek meaning of apnea which means “want of breath”. People with sleep apnea have episodes in which they stop breathing for 10 seconds or more during sleep.

People with sleep apnea do not remember these episodes during the night, unless they awake to a gasp. Some of the potential problems may include morning headaches, excessive daytime sleepiness, irritability and impaired mental or emotional functioning, excessive snoring, choking/gasping during sleep, insomnia, or awakening with a dry mouth or throat.

Some simple questions to ask yourself are: Have you been told that you snore?

Do you often feel tired, fatigued, or sleepy during the daytime?

Has anyone ever told you that you stop breathing while you were asleep – or- Have you ever woken yourself up with a gasp?

Do you take more than one medication to control high blood pressure?

Are you a mouth breather? Do you need to use the bathroom multiple times at night?

Is your body mass index greater than 28?

If you answered yes to more than two of these questions, or if there is anything else in this column that makes you believe you may not be getting the quality of sleep you would like, please discuss these with your physician.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

When we were all young children, most of us got plenty of sleep, and for that matter, we didn’t think much of it. Our parents told us it was time for bed and we went to bed. We slept until the morning at which time we were woken by our parent’s gentle touch.

As we progressed into our teenage years, our responsibilities increased. This typically led to staying up later and getting up earlier to be able to keep up with these added responsibilities. Today, it seems that getting enough good sleep is even more of a challenge for our teenagers.

One of the contributing factors of this teen sleep crisis is that parents are not as strict with setting rules for sleep as they were when their children were younger. It is not uncommon for teenagers to say to their parents they are going up to their room to do homework and then go to bed.

I recently asked my daughter (a freshman in college) what time she generally “packed it in” and settled down to fall asleep. She told me that after she finishes her homework she will lie in bed and watch something on her laptop until she feels sleepy. This trend is an antithesis to good sleep and one that must be discussed with every teenager by their parents.

Rules about electronics, which include cell phones, computers, games and the television, are especially crucial. In a study done by the National Sleep Foundation, it was determined that teens who have electronic devices on prior to going to sleep, get an average of 30 minutes less sleep. There are other studies that show that the quality of sleep is also greatly affected by this same practice.

Another, more obvious rule that parents must enforce, is the consumption of caffeine at night. Any form of caffeine should not be consumed after dinner. Studies indicate that caffeine in the system accounts for almost a full hour less of quality sleep. We, and our teenagers, cannot afford this deprivation of sleep.

We all start our days at different times. For the teenager, getting up to get ready for school can start pretty early. There is a “start school later” movement that recently received a powerful boost from the Centers of Disease Control and Prevention (CDC). The CDC report showed that teenage students have biologically different sleep patterns and needs than in other stages of life. Starting school a half hour later or more provides the teenager the opportunity to consistently get a better night’s rest.

For the teenager, managing homework and extracurricular activities is also definitely a barrier to sufficient sleep. We as parents must discuss this with our children to provide support with time management. If necessary, we must also not be afraid to discuss this with teachers and coaches if our teenager is struggling to get everything accomplished, thus affecting their sleep patterns.

As adults, many of us have our own routines that could use a revision to get more quality sleep. That is a subject for another time. As parents, it is our responsibility to guide our children to practice good habits. Discussing and enforcing better sleep habits is a gift that keeps on giving.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

In the first segment of this series, the discussion involved the role of caregivers in early dental care. Prevention starts as early as 6 months into pregnancy and continues with essential steps early in a child’s life. The second segment discussed dental care for children as they develop. In this final segment I will discuss easy prevention and maintenance steps to take to help ensure dental health for a lifetime.

As I stated a few weeks ago, in preventive-based dental practices we go far beyond saying to patients, “you need to brush and floss more.” We truly believe that dental disease, both dental caries (cavities) and gum disease, is very preventable. However, we recognize that not every individual is equal when it comes to susceptibility. Each person presents with their own unique genetic pool, good and bad habits, number and position of teeth, and willingness to truly make a change. The one constant is that most of us have room for improvement.

Here are 4 simple things that will help maintain dental health for a lifetime:

Professional Maintenance – It is easy to put professional hygiene visits on the backburner. We are pulled in many different directions in life, and the absence of pain in our mouths sometimes grants us permission to skip regular dental appointments. Some people will use the excuse of lack of insurance for not going on a regular basis. The most important thing you can do to prevent dental disease is to commit to a lifetime of professional dental visits. This is a choice. Your cell phone costs more per year than these visits will. Some people require four visits a year to maintain health and others may only require one. There are no set rules. However, it is up to you to make the commitment.

Home Care – Most people have significant room for improvement with their home care. Coaching, in anything, increases an individual’s potential for improvement. Think of us as your dental coach. We routinely ask patients to bring their toothbrushes with them to their appointments to review technique. As simple as it sounds, constant evaluation and improvement of your home care can only decrease your chances of dental disease.

Diet – What we put in our mouths, when we do it and how often are all choices as well. As with everything, some people can get away with things that others cannot. Decay rates are different for different people and can change during the course of a lifetime. This is an important topic to routinely discuss at regular visits.

Dental Orthotics – This is in reference to any oral appliance, typically worn while sleeping, but sometimes there are some worn during the day. This is another situation where absence of any symptoms sometimes allows us to ignore what is really going on. It is easy to get someone to wear an appliance in their mouth if they present with TMJ issues or headaches. On the other hand, it is often difficult to convince someone to routinely wear a nighttime appliance if they have no symptoms. For example, people who have had braces should be wearing retainers. People who have sleep apnea may have the option of wearing an oral appliance to treat this problem and sleep better. However, those who have evidence of clenching and/or grinding are the most undertreated. It is my firm belief that if more people committed to unfailing routine use of a properly made nighttime appliance (if they show any indications they need it), many potential dental problems would be avoided.

I believe that most dental disease is preventable. What it takes to prevent dental disease in one person may very well not be the same for another. Choose and commit to these four things and you are guaranteed fewer dental problems over your lifetime.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Last week’s column was about oral care for mothers-to-be and babies. Preventive care truly does start before birth. This week we journey past those early years of life.

In preventive-based dental practices we go far beyond saying to patients, “you need to brush and floss more.” We truly believe that dental disease, both dental caries (cavities) and gum disease, is very preventable. However, we recognize that not every individual is equal when it comes to susceptibility. Each person presents with their own unique genetic pool, good and bad habits, number and position of teeth, and willingness to truly make a change. The one constant is that most of us have room for improvement.

It goes without saying that preventive care includes regular visits to the dentist. Based on my experience, even many of those who visit the dentist on a regular basis have significant room for improvement. However, it is up to your caregivers, hygienists and dentists, to have that preventive frame of mind to go beyond just telling you to brush and floss more.

Technique is vital when it comes to home care. Although daily removal of plaque (the thin, sticky film of bacteria that creates cavities and gum disease) can be accomplished with a manual toothbrush, the proper power toothbrush is more appropriate and effective for most people. We routinely ask patients to bring their toothbrushes with them to their appointments to review technique. The same goes for the water pik. Think of your dentist and/or hygienist as your dental coach. Coaching, in anything, increases an individual’s potential for improvement.

The same approach goes for kids. Although we do the same thing with children, they need that additional coaching from home. The best way to guide your family to good oral health is to lead by example. Parents should supervise toothbrushing by children younger than age 8 to make sure they are doing a thorough job. This also goes for flossing. This is done until the child is consistently getting good homecare reports at dental visits.

The challenge of good home care increases with the addition of braces. Children and adults in braces need extra coaching on technique and more time spent on their daily routine. I am a firm believer that preventive visits to the dentist should increase during orthodontics. There is too much at risk during this time and the extra professional care and coaching are vital to escaping the pitfalls of poor homecare while braces are on.

As life goes on, your genetic make-up, the amount of professional care and coaching you receive, your effectiveness at home, and your willingness and ability to improve, will shape your oral health. The fact of the matter is, there are those who need more professional care and more rigorous homecare than others.

As I stated earlier, I believe that most dental disease is preventable. What it takes to prevent dental disease in one person may very well not be the same for another. Between finding the right fit with a dental office, utilizing the coaching expertise of those individuals, using the right homecare products, and always striving to improve, excellent oral health for a lifetime is possible.

In the final segment of this series next week, I will discuss some simple ideas to maintain good dental health for your entire adult life. It is simpler than you think.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

September is almost over!  It’s crunch time to get everything done that we haven’t gotten done during the rest of the year. For those with remaining dental benefits, it’s also the time of year to consider utilizing those so you don’t lose them.

Unused dental benefits go directly back to the insurance company, which generates hundreds and hundreds of thousands of dollars for the insurance companies each year. Dental insurance companies count on the fact that many people will not claim their $1000 or so in benefits by the end of the calendar year. Those with dental benefits should look for legitimate means to use these benefits before they are lost.

For example, perhaps a crown has been recommended by your dentist, but you have procrastinated about it. It would make sense to consider using those dental benefits before the end of the calendar year. This allows a whole new round of dental benefits to be used for unexpected dental needs the following year, and maximizes the value of the premiums paid.

Remember, insurance companies are in the business to make money. They don’t want you to use your dental benefits. If the balance (co-payment) you will owe for the dental work that needs to be done is too much for you, consider financing options through your dental office. Most dental offices offer interest-free financing to patients for up to 12 months. Financing your balance in this way may make more financial sense than throwing money away to fund the insurance company’s pocketbooks.

Another thing to consider as the end of the year approaches is the use of flex spending accounts. Many employers now offer pre-tax flex spending accounts for healthcare expenses. Often underutilized, these are excellent mechanisms for saving about 20 percent on needed dental care. If you are paying for your dental insurance premiums, it may even make sense to fund an available flex spending account with that premium money instead of, or in conjunction with it.

For instance, if you are anticipating the need for $3000 in dental care, opting to place the $3000 in a flex spending account can save the income tax on those monies and can usually be used as soon as January 1^st. If you have money left in a flex spending account, remember to check with your employer to determine if that money needs to be used by the end of the year. You don’t want to lose that money either.

As you begin to make financial decisions for the end of this year and for the upcoming year, consider a discussion with your dental office’s financial person. They are often an untapped wealth of information and can usually thoroughly and knowledgeably discuss your dental financial options with you.

And, don’t wait too long. Dental office schedules get full quickly this time of year with patients trying to use dental insurance benefits and unused flex account money. Maximize your hard-earned dollars.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com