Tuesday, April 10, 2012

Insurance Dependence

      Our doctor, Fred Troxel, recently volunteered his services at a community heath fair. I tagged along to help with the dental screenings, excited at the chance to help pass along some beneficial information. Reaching out to a population that is seemingly under-served brought a very important subject to light, insurance dependence. Majority of who sat in our chair at the health fair explained that the reason they have not been to a dentist in years is because they don't have insurance. Does this sound familiar? Too often the question countering a proposed dental treatment is, "Will my insurance cover it?".

 I raise the question,
How dependent is your health on insurance coverage?

     Challange yourself with this question next; Who decides what is best for your health? Are you in the drivers seat, choosing the best possible treatment and preventive care for yourself, or is your insurance company? I acknowledge that with the state of our economy medical costs can seem overwhelming. Yet, can you put a price on your health? Is keeping your teeth for the duration of your life worth something to you? Each of us will have a different answer to these questions.

     What are your expectations of dental insurance?

    There can be misconceptions about exactly how dental insurance works. It's signifigantly different than most medical insurance plans.The average cost of a dental plan is around $25 a month. Over the course of one year it adds up to $300. This total is compartivie to the cost of a comprehensive dental exam and hygiene appointment combined. Dental insurance usually has limitations to how much they cover in the period of a year. If there is major work to be done, do not expect more than one to two thousand dollars coverage per calander year. There are some plans that expect you to be a patient at a specific denist of their choice, therefore removing your ability to choose your own practicitioner.

   I often help my patients become clear about who or what is directing their choices for health. There can be many barriers to obtaining optimal care.

Some examples of personal hurdles to overcome include;
  •  fear of the unknown
  •  anticipation of pain
  •  financial
  •  level of priority
Regardless of what barriers may be present, try to identify what role insurance plays in this. Often, when the responsiblity of insurance is cleared the true reason for not taking the best care of yourself is revealed, and only then can you start to face your true hurdles.

Thursday, March 22, 2012


Cause, effect, or a process of the two? 
   Stress is a term that is very commonly used, yet difficult to define. Each and every one of us has experienced some degree of stress, and most likely deal with it day to day, yet do we really understand this influx of homeostasis? Is stress more psychological, physical or emotional? Does it cause the body and mind to change or is it a result of changes to the mind and body? 


How much control do we really have over stress? 
   Stress does not discriminate based on age, sex, color, socioeconomic status or wealth. It starts affecting us in the womb and has the ability to be present till death. It is easy to downplay the emotional stress of a child before realizing that as we age we develop the coping skills necessary to deflect stress throughout life. Children can not rationalize and comprehend the psychological and emotional changes they feel. Adults often struggle with these coping skills too. I myself had an inordinate amount of stress this past year and thankfully had the ability to be open enough to learn the skills necessary to survive. 
 Psycological affecting the Pysiological
(mind -> body)
   Our bodies are amazing machines, incredible to think that mind thoughts can change our physical state. A wonderful way to portray what capability emotional stress can affect your physical body is the PH example. Our bodies have a normal range of PH, or alkalinity. It is usually desired to be in a more alkaline state verses an acidic state. This can be controlled by many factors, but mainly diet. When entered into a stressful state, PH drops and the body instantly becomes acidic.  

Physiological affecting the Psycological
(body -> mind)
   There are many medical conditions that can cause the mind to be stressed. Any situation that results in a change of neurotransmitters and chemicals in the brain can result in psychological stress. Or consider a physical injury that inhibits someone to do things they normally could, this could result in an emotional stress. 
Cortisol is a steroid hormone produced by the adrenal gland as a response to stress. It is an extremely interesting hormone that I am learning more about. Cortisol's primary functions are to regulate blood sugar, suppress the immune system and aid in metabolism of fats, proteins and carbohydrates. Unbalanced, this hormone plays a role in the belly fat that can arise from stress and the inability to fall asleep at night and be alert in the morning.

Worrying is a waste of your imagination
         Has your mind ever been taken over by a stressful situation? That runaway feeling of the mind, when there is a constant stream of out of control thoughts that run through every possibility that could arise from your situation. The repetitive mind pattern that keeps us up at night. It's a treadmill sort of effect, interrupted sleep causes disruptive cortisol levels, increased stress and unclear thoughts that alter perception of reality.
  The Power of Now , a book by Eckart Tolle, is an amazing reference on how to become conscious and gain control over the process of thought. It was life changing for me to be able to quiet the constant stream of thoughts. Let me share with you some of the ideas; 

To find peace, become conscious of the mind. Start to be aware of the times that your mind is talking. Separate yourself from the mind, look at the stream of thought in kind of a humerous way, as if saying, "there you are again". You'll find that this disarms the thought process and little pockets of quiet start to emerge. These breif moments have the ability to grow as you become more concious.

Know that worry is truly a waste of imagination. You are imaginng things that have not happened yet and you have no way of knowing how a situation will result. Do not worry, do not imagine the worst case scenerio. All that arises passes away. 
Offer no resistance to what is.
Allow the present moment to be and
 to accept the impermanent nature of all conditions.
(E. Tolle)

Wednesday, March 7, 2012

Continuing to Learn

As I prepare for my trip to Boston to participate in a two day seminar with Mary Osborne, I am called to reflect on the importance of continuing education.

  I am a health care professional. With my official title belongs a responsibility to gain updated and accurate information. If my learning had stopped when I left college I would still be "cleaning teeth". Thankfully I've had amazing mentors, begining with my Mother, a practicing dental hygienist for over 30 years. She installed my enthusiasm for dental health while I was still in school. We would take advantage of family dinners during college break to hash out the best ways to address agressive periodontal disease or pregnancy gingivitis while everyone else at the dinner table cringed! Moving through my career, that enthusiasm propelled me to where I am today.

My philosophy is to search for the impact that will lead each and every one of my patients towards living a healthier life.

Continuing education is required for all health care professionals in the nation. It's purpose is to ensure that licenced providers keep updated and current with consistent guidelines and information, yet curiously the only strictly required courses for dental hygienists are CPR , "Preventing Medical Errors" and "Domestic Violence".

Going beyond the required is an individual choice that separates the lacksadsial professional from one who passionately cares.

This week Mary Osborne, a leader in effective communication and facilitation, is offering a course in Boston called Continuing to Care, A Team Approach to Periodontal Therapy. Her co-instructor, Dr. Mike McDevitt, is one of the best periodontist in the Country that intends to incorporate the latest information on periodontal disease and treatment. I'm looking forward to gaining new information that I'll be able to use when I get back to work next week. The most impactfull course I took was with a local Key's dentist. He is the one who passed on the information about sleep apnea. Now that was life saving information that didn't require me to travel far.

Regardless of what area of health care you are in, extended learning could be the most important thing you do for the progression and vitality of your career. It keeps me motivated and passionate about health care!


Wednesday, February 29, 2012

Obesity and Periodontal Disease

Exercise is Awesome!
   There are so many benefits to exercise that all help to increase longevity. Physical activity can improve our mood by stimulating various brain chemicals that influence feelings of happiness and satisfaction. Exercise  also improves self image and confidence, boosting self esteem. Bundles of research shows that stress can have very negative impacts on our health and longevity, but exercising buffers the effects of chronic physiological stress.

Imagine yourself on a brisk walk, your arms and legs are moving, feet hitting the ground, fresh air in your lungs, blood pumping through your heart and entire body. Actively lowering your risk for heart disease, diabetes, stroke, depression, high cholesterol, and arthritis.
 Feels great, right?!

Let's add another benefit ~ Lowering your risk for Periodontal Disease

     To begin understanding this concept, let's talk about inflammation first. Inflammation is your bodies way of responding to pathogens, or a stimulus. The vascular system moves plasma and leucocytes toward the affected area in an attempt to rid the body of the pathogen. Periodontal disease is an inflammatory disease with a clearly defined stimulus, Bacteria. New research has pointed to an unsuspected risk factor of periodontal disease, ObesityThe role of being overweight significantly raises the risk for periodontal infection. The increase of fat cells overstimulates the inflammatory process. 
     Diabetes type II is a later in life onset usually caused by diet and lifestyle. The body becomes resistant to insulin due to lack of sufficient exercise and overconsumption of refined sugars. Usually a making a lifestyle change is the first step in correcting this serious health issue. Diabetes and periodontal disease are reciprocal of each other; active periodontal infection effects glucose levels, and uncontrolled diabetes effects periodontal disease. 
     Taking a good look at lifestyle, including exercise, diet, and stress can bring the awareness needed to make changes that could add years to your life. 

Exercise Euphemisms
I've found a passion for exercise and health a very young age. Currently I'm loving  Bikram Yoga .Through the years my personal philosophy changes, flowing with events and responsibilities in life.
 The most consistent aspect that I am confidant sharing is:
Just Keep Moving.
Don't get stagnant in life, quit making excuses and do something good for yourself.
Swim, walk, jog, bike ride, play tennis, do some yoga poses, play tag with your kids.
Move for at least 20 minutes a day.
When there is the time, the ideal amount of time to dedicate to exercise is 40-60 minutes.
Challange yourself to be healthy.

"Never too late, never too old, never too bad, and never too sick to do this and start from scratch once again."

Exercise is better than Prescription Drugs for pain.

Saturday, February 25, 2012

Sleep Apnea ~Dental Professional Red Flags

Sleep Apnea  sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour.

Sleep Apnea Elevates Death by 46%

Sleep apnea is a condition that is overwhelmingly wide spread and common, yet seriously under diagnosed. If left untreated it can lead to hypertension, heart disease, and stroke. All health care professionals should be current with the information out there. Last year I attended a two day class that focused on identifying red flags during dental appointments. Day one back to the office and the knowledge was applicable, and continues to be on a weekly basis. I want to share this information with everyone in hopes that you too can help bring awareness to your patients.

The Vortex of Red flags
Seemingly simple signs to look for, that when observed can start the whirl of co-discovery 

  • Chipped Anterior Teeth ~ Specifically # 8, 9. We've all seen this scenario, 8 and/or 9 wearing down, where the canines are not affected. It's not the side to side grinding that catches the cuspid rise, but just straight anterior. Here is what's happening: as the airway is blocked, the patient juts his jaw forward in an attempt to gain airway and O2. 
  • Acidic Wear on Posterior Teeth ~ Acid Reflux. Ask about it, get your patients aware. Pitting on mandibular posterior teeth is usually caused by acid reflux that occurs during sleep. With or without the presence of sleep apnea, acid reflux is an important conversation to have. Another under diagnosed condition that can occur without conscious knowledge. In the case of sleep apnea, the pressure in the esophagus caused from the body trying to gain O2 results in the rise of stomach acids. 
  • Missing Four Premolars ~ Common practice of orthodontists to remove four premolars in an effort to accomplish a desired outcome. I strongly believe this is not a sound practice, but am not educated in orthodontics, so it is an opinion. Here's what I do know; instead of maximizing jaw growth by making more room for the crowded teeth, growth is stunted or hindered when the premolars are removed and anterior teeth retracted.  The mandible follows the growth of the maxilla, and an underdeveloped mandible leads to airway obstruction issues in adult hood. 
  • TMD ~ Temporal Mandibular Disorders. Clicking, popping, crepitus, pain, headaches. You may start to notice a correlation with the four missing premolars. Pretty consistent with misplaced occlusion and retracted mandible.
  • Snoring ~  If you are starting to recognize a couple of these red flags with a patient, go ahead and ask if they snore. It is most likely an issue that affects other areas of their lives, like relationships. Even without the presence of sleep apnea a discussion about snore relief could change lives. 
  • Sleep Patterns ~ It's not a common question to be asked at a dental visit, but get curious about how well your patients are sleeping. "How well do you sleep at night?" It can open the door for a wide range of conversations, encompassing health and lifestyle, but keeping in mind the red flags for sleep apnea; listen for answers like, "Not well at all, I'm up numerous times at night and I find myself tired during the day". Usually someone who is suffering from sleep apnea will wake often during the night due to the lack of O2.
     After starting to become familiar with these signs, you may be surprised how many people it is applicable to. Where do you go from here? 
Encourage your patients to follow up with a physician and possibly a sleep study. Be entirely clear how important it is for a full diagnosis with a doctor. The gold standard for treating sleep apnea is a CPAP ( continuous positive airway pressure) machine. Our role is to help bring conscious awareness to a serious and life threatening condition. 

Things I'm Loving Right Now

   With flu season in full swing, here are a few products and ideas that can help to keep any viruses at bay. 

   XClear xylitol nasal spray is sitting on each bathroom counter in my house. Ingredients listed include grapeseed extract, saline and xylitol. 

Xylitol  is a naturally occurring 5-carbon sugar alcohol found in many fruits and vegetables and produced in small amounts by the human body. 

Xylitol has the same sweetness as sugar but with 40% fewer calories and none of the negative tooth decay or insulin release effects of sugar. 
Bacteria can't metabolize xylitol, so in effect they starve to death, reducing their reproduction and growth properties. 

Check out this study, showing how using a nasal spray with xylitol reduces ear infections in children: 
 Abstract; xylitol nasal spray reduces ear infections

I keep this in stock at my practice for my clients to purchase. Unfortunately, living in the Florida Keys limits our access to some products. Here's an easy link to find it; http://www.xlear.com/

Some simple lifestyle tips for being healthy in flu season include the normal get plenty of rest, lower stress, maximize immune system boosters such as vitamin C.

  • Build up your vitamin D supply. There is an abundance of research pointing to the need for more vitamin D in our diets. Supplements are recommended because we just aren't getting enough through diet. Here's a great link to a blogger that gets down to the nitty gritty with Vitamin D. 

Vitamin D, marksdailyapple

If you feel like you may be coming down with a cold, here are some lifestyle tips to reducing the life of the virus.

  • Drink plenty of water! simple. 
  • Rest, rest, rest
  • Limit alcohol consumption 
  • Limit sugar. 
    • sugar promotes inflammation in the body
    • There is research that shows sugar impacts the immune system 
Overall, being aware of how your body is handling stressors is important. Keep your life as serene as possible and become conscious of how you are reacting is part of maintaining your healthy lifestyle!