The Current Crisis in Local Dental Care

There is a dental care crisis in our area. It seems that Delta Dental, who insures many of the people of the valley, is upsetting a lot of folks. The City of Salem is switching to Delta for dental insurance on Oct. 1st. 

I just saw a patient at the store who will have Delta, and now must see somebody on their provider list or dental chair pixabay pub domain free commercial -2450751 640she gets no coverage at all. 

Meanwhile I've heard that Delta reimburses dentists at different rates. I have heard that their long-term providers get reimbursed at a higher rate than new providers. I have reached out to a specialist/provider to see if they tried to negotiate with them. Due to the small number of providers, historically our specialists and many generalists haven't been providers. Delta may or may not have tried to work with them. 

I can't see a huge company like Delta Dental working with my individual practice. But I will continue my research to see what options there may be.

I tried to explain "value" to the patient I encountered in the store. Like most patients, she's only thinking about what it's going to cost her. She made it clear she doesn't want to change dentists, however, she will to save money. Of concern to me is the quality of care these patients will receive (or be denied).

The reimbursement schedule Delta presented to me for the city's plan definitely dictates volume practice, not quality. In addition, this means cutting costs where ever possible -- like lab choices. We use local labs--supporting local businesses and having complete knowledge of the product and its quality. We don't do any mail order: these are often products made outside the U.S. and we have no certainty of the quality of the product or the materials used.

All of this for "insurance" that really isn't insurance. It's a predetermined dental benefit payment plan. Clearly it doesn't insure anything like your home, car or medical insurance.

I fear that this set payment for procedure will exclude many dentists. What I fear more is what the future holds for patients who must sacrifice both quality and true value in exchange for something they think will reduce their cost.

It is important that patients understand what they are getting: most dental policies (regardless of provider) pay a set amount per procedure. The patient still must pay the remainder of the cost. And, these dental policies have a limit on the amount of money they will pay to or for a single patient within a year. When insurance refuses to pay for necessary procedures, the patient suffers because the problems only become worse. In the end, I fear that it might cost them more than having no insurance.

These programs that refuse to pay any portion of the cost of dental work if the dentist is not in their network (which applies to many dental plans). This forces patients to leave their trusted dentist or to spend extra money while still paying premiums. We all live on budgets, and we want to maximize our available benefits with freedom of choice and the ability to make our own decisions about the dentist we believe provides the best value for our dollars.


Childhood Environment Determines Disease in Adulthood • Published on Published onSeptember 15, 2017 • Edit article • View stats Caroline Wallace, DDS • 5 • Like1 • Comment0 • Edit article I read an article yesterday from Smithsonian Magazine tha

I read an article yesterday from Smithsonian Magazine that provoked thought. It has been proven that periodontal disease has a direct link to cardiovascular disease, diabetes, and premature, low birth rate babies.

child-portrait sm - graphicstock - BFGry6KNj


Constant exposure to oral bacteria, inflammation, results in bacteria adhering to heart vessels, decreasing the diameter, making the heart work harder to move your blood, resulting in high blood pressure. I compare this to one's garden hose. We've all stuck our finger in the hose and felt the slime buildup from tap water.


Exposure to oral bacteria, inflammation, during pregnancy is associated with pre-term, low birth weight babies, is especially prevalent in Southwestern Virginia. Some medical insurance will cover the cost of periodontal therapy in an attempt to avoid the extra medical expense of a premature birth.


Inflammation changing one's DNA is new to me, too. Stress and inflammation just are not good. This article makes sense. Nothing is constant. Some people believe this is the premise of evolution.


Part of the explanation from the article says:

"This is not the first time research has shown that a child's environment growing up can help determine his or her future health. This isn't even the first time that scientists have linked environment to DNA methylation and methylation to health (these studies have been done in mice). This is, however, one of the first and most complete investigations that show that epigenetic modifications created by the environment have lasting effects on human health."


I encourage you to read the article here:

How to Choose the Right Toothbrush

Several factors are important in choosing the best toothbrush for you. These factors are fairly simple, but sometimes one or more is forgotten.

1. Choose a soft-bristled toothbrush. Hard-bristled brushes can damage the enamel of your teeth, particularly if you are a vigorous brusher.medic-sml  310-738-840

2. Choose a head shape that fits into your mouth comfortably and reaches all of your teeth – particularly your back teeth.

3. Handles are of four types:

          (1) flexible – easily maneuvered;

          (2) classic – rectangular and straight;

          (3) gripped – prevents slipping while you brush;

          (4) angled – shaped to help you brush areas of your mouth that are otherwise difficult to reach.

Choose the handle that is comfortable, does not slip, and does not injure your mouth.

4. Look for ADA acceptance. The seal of the American Dental Association assures you that the toothbrush meets quality standards: bristles do not shed, no sharp or jagged edges of bristles, components are safe to use in your mouth, durable handle, and the brush can be used by the average adult to accomplish the goals of brushing.

Price is not an important factor in choosing a toothbrush. It is not necessary to spend a lot for a good toothbrush if the other factors are present. Just don't buy something that is too inexpensive and that does not meet the standards. If you are uncertain or you have questions, ask your dentist.

Happy brushing!

A Word about Sealants on Children’s Molars

Sealants on children’s molars protect them from decay. Probably the most difficult part of the mouth to brush and floss is the back of the mouth where the molars are located. Brushing molars can be particularly difficult for children. Further, due to the irregular shape and the roughness of these teeth, they often becomedentist-428646 640 a breeding ground for food, bacteria and cavities. Sealants on children’s molars have become very popular as a way to protect these teeth from food, acid, and bacteria.

Sealants have been described as a “raincoat” for molars. A sealant is a thin, protective coating that attaches itself to the surfaces (particularly the chewing surfaces) of the molars. Sealants are made of dental materials or from plastic. Some sealants are clear and allow your dentist to monitor them for any development of decay. They are also used regularly to protect teeth showing the beginning of decay in an effort to stop the decay from becoming a cavity.

Why Consider Sealants?

Sealants reduce the risk of decay in molars by almost 80 percent.

In a 2016 report from the Centers for Disease Control (CDC) the agency endorsed the use of sealants for children of school age. The report indicated, however, that only about 43 percent of children between the ages of 6 and 11 actually have sealants on their molars. Specifically, the report said, “school-age children without sealants have almost three times more cavities than children with sealants.” Most dentists recommend that a child’s molars be sealed as they come in (age 6 for first molars; age 12 for second molars). Sealants can also be used for teens and adults.


The application of sealants is a simple and painless process that your dentist can perform in the office. After cleaning the teeth and drying the molars, a gel is applied to the surface of the teeth. This gel contains an acidic compound that makes the tooth surface rough. This makes it easier for the sealant to adhere to the tooth. After mere seconds, your dentist will rinse off the gel and dry the tooth again. The sealant is then applied to the tooth, and a blue light is used to harden the sealant.

Unless a patient is allergic to something in the materials used, there are no side effects of applying sealants. These sealants contain a very small amount of BPA, but not enough to cause any harm. They contain less BPA than a receipt, cosmetics, or dust. Sealants typically last several years, and then need to be replaced.

Some dental insurance covers the cost of sealants; some does not. You might want to check with your insurance provider before your dental appointment so you can have an informed conversation with your dentist. 

Thumb Sucking, Pacifiers, and Your Child’s Teeth

I am often asked how thumb sucking and pacifiers affect a child’s developing teeth and mouth. Is one better than the other? The short answer is no, there is no difference between sucking a thumb, fingers, pacifiers, or child w pacifier - pixabay free commercial use-1506941 640other objects. Sucking behaviors often comfort, soothe, help children fall asleep, and support feelings of security. But they should stop at an appropriate time.

Children usually outgrow sucking behaviors between the ages of 2 and 4. It is important that they stop thumb sucking and sucking on other objects (including pacifiers) before their permanent teeth emerge. Continuing thumb sucking can alter the development of your child’s mouth, the alignment of her teeth, and cause changes to the roof of her mouth.

If your child continues thumb sucking beyond a typical age, or if you begin to notice any changes in your child’s teeth, consult your dentist.  If you are having difficulty helping your child quit thumb sucking or pacifier use, ask your dentist for help.

To your child’s healthy teeth and mouth!


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