J. Peter St. Clair, DMD Blog
DENTAL INSURANCE UPDATE – PART 2
November 21, 2016
Last week I explained how dental insurance works. This week I will break down the general differences between dental insurances, some things to consider when using your dental insurance, and when it makes sense to consider purchasing insurance if you don’t have it.
I get asked daily by patients who are either self-employed or are not offered insurance through their employer, “Should I consider getting dental insurance?” In most cases, in my opinion, it does not make sense to purchase dental insurance on your own. This goes back to last week’s column as to how dental “insurance” is set up to begin with.
DENTAL INSURANCE UPDATE – PART 1
November 14, 2016
Most dental offices are bombarded daily with questions about dental insurance. “Do you take my plan? How much is covered? Why is dental insurance coverage so bad?” These are just a few of the questions we hear daily. So, why is dental insurance the way it is?
Dental insurance was first offered back in the early 1970’s. Back then, the first insurance companies offered a yearly maximum benefit level of $1000 per year per patient. In 2016, those insurance companies, and now many others, offer an average yearly benefit of $1000-1500 per year. Yes, you read that correctly; it has not changed much. However, back in the 70’s you could have gotten a lot more dentistry than you can today on that same $1000. Why hasn’t it changed?
There are many answers to this question. The bottom line is that raising the dental insurance limits would be extremely unprofitable for insurance companies. Here are some reasons why.
First is the “use” factor. Many patients who have dental insurance use their insurance right up to that yearly maximum. This is generally not the case with other types of insurance. In fact, the entire dental insurance model is based on a certain percentage of those insured not using their benefits at all. If the yearly benefit was higher, the premiums would need to be much higher for the insurance companies to make a profit. This would destroy the model and there would be many fewer patients signing up for those plans.
The second reason is pre-existing conditions. Many dental problems are often ignored for years and patients will often wait until they have “insurance” to take care of their problems. This is why many insurance companies have a “wait period” for certain dental procedures. When that patient finally has dental coverage and the dentist tells them they need three root canals and three crowns they are shocked to hear that their insurance will only cover a small percentage of the treatment. There is no dental insurance available to cover situations like this because it would be extremely unprofitable for the insurance companies.
Next is the fact that dental problems are much more common than many other health problems. This goes back to my first point of the “use” factor. Look at how expensive medical insurance is. For many people, they may go for routine check-ups to their doctor, but a much lower percentage of patients use their insurance for more costly procedures. However, we all need the health insurance in case of that catastrophic event that would otherwise bankrupt us. For dental insurance companies to remain profitable they have to charge a high enough rate to offset the “people using it” factor, but also a rate low enough for it to be “worth it” for the typical consumer.
And, when you think it couldn’t get any worse, it does. These same insurance companies are cutting reimbursements to dental offices that have participated for years. In addition, there are more and more “discount” plans available which appear more attractive to employers. This continues to brainwash the public that dental insurance is the answer.
Next week I will expand on this with a discussion of the difference between the different kinds of dental insurance available: those you can go to whomever you want and those where you have to pick a dentist from a list. The final column of this series will give you suggestions for getting the dental health you need regardless of insurance.
ATTENTION DOG OWNERS
November 10, 2016
I have written before on the benefits of Xylitol, the sugar substitute that possesses 40 percent fewer calories than sugar and has been shown to decrease the amount of cavities that people get. It can be found in specifically formulated things like gum and mints. However, it is important to know that xylitol, even in small quantities, is toxic to dogs.
The dental benefits of xylitol have been known since the 1970’s. Xylitol is not metabolized by the decay-causing bacteria Streptococcus mutans (S. mutans), making it nonacidogenic and thus noncariogenic (not decay causing). Studies have also indicated xylitol decreases the levels of S. mutans in both plaque and saliva. As a result, patients who use xylitol have demonstrated a reduction in decay.
Revitalize Your Smile with Porcelain Veneers in Rowley
November 3, 2016
A quality run can do so much good for a person, not just physically, but mentally as well. You can feel accomplished even after the most relaxed of days, or blow off steam from a stressful one. Time seems to stand still and all is right with the world for those few miles. Running has helped you stay fit for years, and you wish fixing your smile could be as simple and long-lasting. There so many different things wrong with your teeth, you don’t know how you could fix everything. Dr. J. Peter St. Clair and Dr. Leonard Strauss can give you that perfect, enduring smile with porcelain veneers in Rowley. (more…)
The Biggest Loser
August 6, 2015
I will wrap up part 3 of my series on easy ways to maintain dental health in adult life next week. I was going to write on Cecil the lion last week but wanted to follow the story a little longer.
By now, everyone has heard of Cecil the lion’s demise in Zimbabwe at the hands of an “American Dentist.” There has been much written about the fact that the hunter was a dentist. In fact, the day after the story broke about Cecil, The Washington Post published a column entitled “Why dentists are so darn rich.” It quickly referenced how much the “rich” dentist paid for his hunt and then bombarded dentistry as a profession.
Does it matter who killed Cecil? It depends on what you read. There have been many dentists or other dental professionals who have quickly jumped in defending the profession. Due to typical media spin, there seems to be just as much talk about the “dentist” as there is about the obvious other side of this story.
Well, I’m not going to defend the dentist on this story. I am also not going to defend hunting or “trophy” hunting. It doesn’t matter to me personally who killed the lion. Most of the commentary I have seen on this story finds the act deplorable. It you read the paper or watch the news you are quick to realize that there are many people doing bad things in our world. There are also many people doing good. It is up to each of us to form our own opinion; for this story, it should be about the act and not the profession of the actor.
But no, the story of killing the protected lion was not enough. Dentistry is an easy profession to pick on. The “anti-dentite” (Seinfeld reference) group has a never-ending list of topics to choose from. In the column I referenced earlier, the author hits many of the highlights but starts with this:
“At $54,000, the reported price of the trip that an American dentist took to Zimbabwe is nearly as shocking as the death of Cecil, the widely known and universally loved lion he killed while he was there. The neighborhood dentist seems far removed from the upper echelons of medicine, someone who comes in for a few minutes at the end of a cleaning to check your teeth and ask about your kids, occasionally doing a filling or root canal.”
I know a lot of dentists. I don’t know any who “trophy” hunt. I know some dentists who are wealthy by societal standards, either from a lifetime of commitment to their work, or having the added benefit of generational money. I know many dentists who are not wealthy, in the monetary sense, but live extraordinary lives. I know others who are struggling with many aspects of their lives. I know some dentists who are sincere good people and others who do things which I would never associate myself with. This can be said of anyone from any profession.
Who is the biggest loser in this story? Cecil the lion is a big loser. While I am sure we do not know all the facts of this story, it is difficult not to have compassion for this beautiful creature and his senseless killing. The dentist hunter is a big loser in many ways. Many, if not most, believe he deserves whatever happens to him. If you feel that way it should be because of the act he committed and have nothing to do with his profession.
The staff, formerly employed at his dental office, are losers. They lost their job because of his actions. I feel sorry for them. They were not mentioned in anything I read. But, the biggest loser of all, in my opinion, is the media. Only a loser would spin this story to create a headline to read.
The Year for Change
January 11, 2014
A list of New Year’s resolutions is really like a “to-do list” on a larger scale. As with many to-do lists, some of the items on it keep getting pushed down in the ranking of priorities because of the constraints of time. So I have a suggestion to keep in mind when making pledges to yourself about what you are going to do this year: Make purifying your time your first resolution.
Many driven people pride themselves on how many tasks and commitments they are able to take on. Eventually, reality catches up and this philosophy of always doing more becomes counterproductive, as you inevitably have to approach your growing list of commitments at a more superficial level. The simple truth is that getting more done is not a matter of doing more things; it is a matter of doing the right things with your time. In that sense, the answer is often found in “unhooking” yourself from the low-value time wasters that hold you back from giving your full attention to the things that truly drive your success.
You can’t buy more hours in a day, but you can reclaim time for yourself. You can choose to delegate; you can choose to streamline and purge yourself of recurring nuisances that eat away at your productivity. You can choose to say “no” to demands on your time that don’t fit your criteria for being worthwhile. By purifying your time priorities in this way, you amplify the value of your time and you get more out of life.
So as you put together your list of things you want to do over the coming year, be sure to work on another list at the same time: a list of things you don’t want to do anymore. Think of it as a “To-Not-Do” list.
Some of the items on this list may take time and effort to unhook from, such as delegating others to take over certain duties. Some of them you will find you can drop right away. Of course, this does not include things that you are passing on to say your spouse, like laundry and grocery shopping.
Be ruthless about it, keeping in mind that this is your most precious resource we are talking about. Examine each recurring demand on your time and ask yourself if it’s adding value to your life in an intangible way? Is it enhancing your productivity and improving your life? If the answer is no to both of those questions, the next question becomes obvious: Then why are you doing this?
Challenge yourself right now to sit down and create your own list of things to not do in 2014. Try to come up with at least five items. This is a great way to start the year with a feeling of liberation. This allows you to clear your mind of clutter and award yourself more time and energy to embrace the really important possibilities.
You can create specific lists for different aspects of your life, like your health. Changing your habits takes effort and the awareness that you want the change in your life. I look forward to sharing ideas on this subject throughout the year.
5 Reasons People Avoid the Dentist
January 20, 2013
There are five major reasons that people do not get the necessary dental care they need. They are money, time, lack of concern, fear and trust. Let’s take a quick look at each one and see if any of them fit you and what dentists often try to do to overcome these obstacles for patients.
Although you may think that money would be the number one reason people avoid ideal dental treatment, it is not. Even in these tougher economic times, money, although a significant barrier for many is still not the number one issue for most. Yes, dental care in some cases can be a significant investment. With insurance industry’s unwillingness to raise the bar, as I have talked about in previous columns, patients often get stuck with large dental bills. Unfortunately, as of now, we have to face these facts and it does not mean avoiding the dentist.
Many dentists offer payment plans through third party carriers so patients can pay for treatment over an extended period of time. Ask your dentist if they have such an option. The point here is to get a plan. Once a plan is established, your dentist can work with you to prioritize and sequence your treatment. This way, if you need to spread your treatment over a period of time to make it affordable, you can pick away at a well thought out plan.
Time is an excuse. We all use time as an excuse for many of the things in our lives we want to avoid or procrastinate on. The reality is however, if we place something high enough in our value system there is always time for it. But, in order to move something higher up in our value system, we must be educated and come to realize that this particular thing is of benefit to us. This brings me to the most common reason people avoid ideal dental care.
Lack of concern about dental health is prevalent with a huge percentage of the population for a few reasons. Absence of pain is one. Other than “nerve gone bad” need for a root canal, there few things that actually cause pain. Take for example periodontal disease. About 75% of the population has some form of this disease but only 50% of the population goes to the dentist. Why? No pain. This doesn’t mean it is healthy and there are not problems down the road like loss of teeth. It is up to the dentist to educate patients on these types of issues, but people have to actually go to the dentist to get this information.
Some people have fear of going to the dentist….and for good reason, due to bad past experiences or bad information. However, dentistry today should be a comfortable experience most of the time. For those who are still fearful, there are different medications dentists can use to ease the experience.
The last barrier to ideal treatment is trust. For a patient to move forward with treatment, it is essential the patient both like and trust the dentist. Although I am sure that the skills of your dentist are important to you, I am willing to bet that you would not stay with a dentist that you did not like or trust. Find someone you can connect with and build a strong doctor-patient relationship.
21 Suggestions for Success in 2013
January 3, 2013
If you are reading this column, the end of the world did not happen on December 21st and it’s time to think about the ways in which to improve our lives for 2013.
As readership has grown for The Town Common, I thought it was appropriate to re-publish this column so that new and old readers could benefit from this list. It is a great way to start a new year.
These 21 suggestions for success are authored by H. Jackson Brown, Jr. I have a framed picture of these hanging in my office and read them every day. I get comments about them all the time from people saying how much they like them. Cut this column out, hang it on your refrigerator and read it frequently.
1. Marry the right person. This one decision will determine 90% of your happiness or misery.
2. Work at something you enjoy and that’s worthy of your time and talent.
3. Give people more than they expect and do it cheerfully.
4. Become the most positive and enthusiastic person you know.
5. Be forgiving of yourself and others.
6. Be generous.
7. Have a grateful heart.
8. Persistence, persistence, persistence.
9. Discipline yourself to save money on even the most modest salary.
10. Treat everyone you meet like you want to be treated.
11. Commit yourself to constant improvement.
12. Commit yourself to quality.
13. Understand that happiness is not based on possessions, power or prestige, but on relationships with people you love and respect.
14. Be loyal.
15. Be honest.
16. Be a self-starter.
17. Be decisive even if it means you’ll sometimes be wrong.
18. Stop blaming others even if it means you’ll sometimes be wrong.
19. Be loyal and courageous. When you look back on your life, you’ll regret the things you didn’t do more than the ones you did.
20. Take good care of those you love.
21. Don’t do anything that wouldn’t make your Mom proud.
22. (my own) Strive for optimal health……and that includes dental health.
Devastating
November 26, 2012
I mentioned a couple of weeks ago that I was in travel mode for a few straight weeks of continuing education courses. This past week I was in Detroit, which I will discuss below. This coming weekend I was scheduled to travel to northern New Jersey. Well, Hurricane Sandy postponed those plans. My heart goes out to those affected by her devastation and I wish them the best as they try to pick up the pieces and return to normalcy.
This week I would like to discuss two other areas of devastation that I encountered on my most recent trip to Detroit. The course itself was a live-patient course utilizing a unique type of surgical extraction instruments. Although I was very impressed with the course and instruments, there is nothing really more to report that would interest the readers of this column. The two areas of devastation I encountered, however, are worth mentioning.
I saw numerous patients in Detroit who presented with the need for treatment that they could not otherwise afford. Two of the patients I treated needed full-mouth extractions. One was an older gentleman who had recently finished radiation treatment for cancer and the other was a 21-year-old man who has been using methamphetamine (crystal meth). The effects of both of their situations led to the demise of their teeth.
Meth is highly addictive; many users are hooked the first time they try it. Long-term abuse can cause serious dental deterioration, hallucinations, heart failure, brain damage, and stroke, not to mention devastating the lives of addicts and their families.
People think that all drug users look strange, but the reality is that some are normal, good-looking kids, high-school students, even parents. Although my patient did not report any use of drugs, it was apparent from the distinct look of his teeth that he was a heavy meth user.
The signs of possible meth use are many. In addition to physical and behavioral changes, one of the earliest symptoms is gum-line decay of the teeth, caused by both the chemicals in the drug and reduced hygiene (tooth brushing). In more advanced cases, the teeth take on a grayish-brown appearance, then become weak — cracking and breaking easily — and eventually spongy. After long-term decay, teeth take on a goblet shape and the term “meth mouth” is used to describe them. This describes my patient’s teeth exactly. Devastating.
Radiation treatment can have a similar effect on the teeth. It can have both an effect on the teeth themselves and the bone that supports them. My patient had quite a bit of good restorative dentistry performed on him in his younger years but had not seen a dentist for approximately 10 years.
When he was diagnosed with cancer, he underwent radiation treatment without working directly with a dentist. The treatment caused severe dry mouth (xerostomia) which led to rampant decay around the necks of all of his teeth. In addition, the radiation also made his bone extremely brittle, which further complicated the procedure I was doing. Patients who need to undergo radiation treatment should work directly with a dentist and consider intense fluoride treatments and any teeth that need to be extracted should be done prior to radiation treatment.
It is always saddening to see devastation. And, although there is gratification in helping those in need, we should be mindful of the steps we can take in our own individual situations to avoid the unnecessary.
Six Month Smiles
November 11, 2012
Typically, fall and winter tend to be my heaviest time for continuing education. What is continuing education for a dentist? It is a must. As in any profession, learning never stops. If you stop learning, you halt growth both professionally and personally.
Dentistry offers continuing education in every aspect of the profession. Dentists can learn everything from new techniques in “filling” teeth to using Botox. In the next month I am travelling to Detroit to learn some new surgical techniques, New Jersey to learn a different way to do root canals, and Arizona for a refresher course on treatment planning and communication with patients. Travelling and being away from home is not my favorite part of this learning process, but you have to go where the information is.
In the 18 years of continuing my education, I have taken courses that have been career changing and others that were of no interest to me. Recently I was in Indianapolis for an orthodontic course entitled ‘Six Month Smiles’.
Many adult patients are unhappy with crooked teeth. Some of them may have had braces when they were younger and didn’t wear their retainers and others may have never had braces but always wanted straighter teeth. I have numerous adult patients who are currently in braces with an orthodontist. I also have many patients that are not willing to make the commitment to wear metal brackets in their mouth for 2 or more years.
A few years ago I took a course for Invisalign. This is a system that uses scanned impressions of the mouth and provides a series of digitally produced removable clear trays called aligners. The patient wears the trays 24 hours a day and is only supposed to remove them to eat and brush their teeth. The trays are changed every 2 weeks and with each change the teeth are moved. The intended end result is straight teeth. Treatment time depends on the complexity of the movement desired. In my experience, treatment usually takes a year or more.
I have had my frustrations with Invisalign. Certain movements of teeth can be unpredictable. In addition, because the patient can remove the trays, there is a compliance issue. I limited the cases I did to patients who I knew would be compliant and had relatively easy tooth movements.
Six Month Smiles is a system that I am using to replace Invisalign. It uses clear braces and a white wire so they are barely noticeable from speaking distance. And, the patient can’t take them off so it makes the movements more predictable in that regard. Why is it called Six Month Smiles? Treatment is usually completed in 6 months with a range from 4-8 months.
These are considered cosmetic braces. That means that their purpose is to treat the patient’s chief complaint, which is usually crooked front teeth. It does not change the bite relationship and is not intended for people with bite issues. The system is absolutely NOT a replacement for traditional orthodontics in most cases. Traditional orthodontics should always be discussed and considered.
However, this is the perfect solution for many adults. If you wish your front teeth were straight, don’t have gum disease, and don’t have any significant bite issues, this system may be for you. Email me some questions so I can write the answers to them in a future column.
