Dental Water Lines – Part 1
November 22, 2010
This column and the one to follow discuss the issues involved with the water used in the dental office. Water that is used in the dental office is usually the same town water that people drink, use to cook and bathe in. However, in the dental office, the water sits around in plastic tubing and “things” can grow in plastic tubing. Wouldn’t you like to know that the water being squirt into your mouth is clean?
I am bringing this up because it is an often overlooked part of the dental office and is important to consider. The information was obtained from the ADA website.
What are biofilms?
Biofilms are microscopic communities that consist primarily of naturally occurring water bacteria and fungi. They form thin layers on virtually all surfaces, including dental water delivery systems. These common microbes or germs accumulate inside things like showerheads, faucets and fountains, and in the thin tubes used to deliver water in dental treatment.
Will biofilms harm me?
Scientific reports have not linked illness to water passing through dental waterlines. In our environment, we are exposed to countless germs or bacteria. Yet, exposure to these common microbes does not mean that an individual will get an infection or a disease. However, when a person’s immune system is compromised because of age, smoking, heavy drinking, being a transplant or cancer patient or because of HIV infection, he or she may have more difficulty fighting off the invading germs. This is why the ADA encourages patients who may have weakened immune systems to inform their dentist at the beginning of any treatment. That way, the patient and dentist together can make the right treatment decisions.
What has been done to prevent me from being exposed to someone else’s saliva during dental treatment?
The ADA recommends that dentists follow the infection control guidelines of the ADA and CDC. These recommendations include the sterilization of dental instruments and the flushing of waterlines between patients. Additionally, the recommendations call for the installation and maintenance of anti-retraction devices, where appropriate. All these measures should help prevent exposure to someone else’s saliva.
What is the ADA goal for dental unit water?
In 1995, the ADA set a goal for water quality. It called for equipment to be available by the year 2000 that can provide unfiltered water with no more than 200 CFU/ml (colony-forming units per milliliter). That’s the same standard as for kidney dialysis machines, and it’s a goal that manufacturers are working toward. The Food and Drug Administration has recently cleared a number of new products to improve water quality and time is needed to evaluate their effectiveness. The Association encourages manufacturers of new products to submit those products to the ADA Seal of Acceptance program for evaluation.
I will continue next week with some more information.
Do Just What My Insurance Covers
November 19, 2010
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 No. 1 reason most patients gave for not visiting a dentist. So, 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?
Even a benefit that does not cover a large portion of the cost of what you need pay something. 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 you dentist’s responsibility to recommend what you need.
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, or ask your dental office if they have payment plans to spread payment out over time.
I Don’t Get No Respect
November 12, 2010
…….quoting Rodney Dangerfield. I was travelling recently in Baltimore for a meeting. I do what I usually do when I travel – get on the computer and search the web to see what local dentists are doing in that particular area. I know, it’s weird but that’s what the “dental consulting wanna-be / marketing junkie” does.
In my search I came across an office that was reviewed by a new patient who complained she felt that the dentist showed her no respect by assuming that she wanted to be called by her first name. That got me thinking. I do have a place on my new patient forms that says, “Preferred to be called”. I always look at this so I know what to call the person. However, I have never had a patient put “Mrs. Smith” in that line.
It seems that when I was growing up every adult was Mr. or Mrs. or Dr. Today, kids are calling adults by their first names. Many of my kids’ friends call me by my first name without ever having been asked if that is okay.
Recently, I was reading an article about how teachers are seeing an alarming trend these past few years. The students are expecting everyone else to earn their respect. Teenagers make their teachers earn their respect. Until the teacher earns the respect, the student has none for them simply because of the teacher’s position.
The same goes for their parents and even other teenagers. They do not respect people for being older. They do not respect people for things they have accomplished. They do not respect their parents for providing for them and for bringing them into the world in the first place.
I know what you are going to say – this comes from the role models at home. Yesterday, I had an adult (who is a friend) say to their child, “Say hello to Mr. St. Clair”. While it is better than saying, “Say hello to Pete” the salutation is still not completely correct. This, by the way, is very common. Even though I am only a dentist and not a “real” doctor, it still should be Dr. St. Clair.
If a child has grown up around a parent, or other adult role model, who often talks and acts disrespectfully, the child will pick up on that. For example, if a parent is always complaining about their job, and in particular, complaining about their boss or other people they work with… think about what kind of message this sends to kids.
First, the child can begin to lose respect for their parent. They may think “wow, (Mom or Dad) must be a real pushover if they have so many problems at work.” They may also support their parent fully and think “I’ll never let some idiot ruin my life like that. I won’t even give them the chance to!”
I’m not laying the blame solely on parents. Believe me; I understand this cannot be the entire reason behind a teenager’s lack of respect. However, it is part of it.
Back to this patient; while we have no idea what this person is like and do not have the entire context in which the event happened, I think that it is an important thing to think about. No one will ever say that showing “all due respect” to people will degrade society.
Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@dentalhealthforlife.com. You can view all previously written columns at www.dentalhealthforlife.com.
Is your dentist retiring?
November 8, 2010
It has happened. The worst possible thing in the world you could ever imagine has happened to you. The dentist you have been seeing for the last 20 years has retired. What are you going to do?
Many people, including myself, get attached to their healthcare providers. When you build a relationship with your healthcare provider and the office staff, there is a level of comfort in knowing that when needed, there is a person/office that is there to take care of you and you trust. When that provider retires there is a sense of abandonment, obviously not intentional, and that feeling of – What do I do now?
In many cases, the staff members remain, which is not only important for the patients, but also for the new provider. Dental patients go to a particular office for many different reasons. Those reasons range from convenience, insurance coverage (which is not necessarily a good reason and a topic for a whole other column), they love their hygienist, they believe they are getting the best of care, or they have just developed a sense of comfort with the office. I can tell you a fact that I have seen over and over again – no matter how good the dentist is, if patients have issues with the staff, they don’t stay. Staff members play as much of a role in patient retention as the dentist does, if not more. If the staff members leave with the retiring dentist, it can be that much more devastating for patients.
The fact that your dentist retired does obviously mean that you must have a new dentist, whether it be that you stay with the office or you decide to go to a new office. Because of this, and especially if familiar faces remain, it is usually a good idea to give the incoming dentist a try. One thing is certain, regardless of whether you remain in the office or jump ship, things will be different.
Every dentist has their own unique personality, style of practice and philosophy of care. It is unrealistic to think that any one dentist will be that same as another. It is impossible for you as a patient to have any idea whatsoever of the clinical skills of any dentist. For patients, the first thing you will be looking for in your new dentist is whether or not your personality meshes with the new person.
Expect to hear new things. As I said, every dentist is different and has their own unique style of practice. It is up to the dentist to be able to communicate their philosophy of care with you. If they fail to do this it is their problem because you will not be staying.
In general, a retiring dentist has been in practice much longer than the new person coming in. Patients get used to the style of practice they have been in. You need to keep an open mind. I know we have been inundated recently with the notion that change is good. My philosophy is that change can be good.
It will be up to you to decide if this particular change is good for you or not. If you approach this change with an open mind, and your new provider communicates his/her philosophy well, it will give you the best opportunity to decide if it is right for you.
Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@dentalhealthforlife.com. You can view all previously written columns at www.dentalhealthforlife.com.
