Comments by American Dental Association President Dr. Ron Tankersley On the Pew Center on the States’ report
‘The Cost of Delay: State Dental Policies Fail One in Five Children’

CHICAGO, Feb. 23, 2010—”We welcome the Pew organization to our longstanding fight to improve the lives of American children by helping more of them enjoy the good oral health that too many of them now lack. Pew’s presenting its information in the form of a report card makes it easy for anyone to understand that too many kids in too many states are suffering. And we face huge challenges in changing that.

“Even in states to which Pew awarded an A, countless children lack access to dental care and suffer as a consequence. These children are just like your children. Except these children can’t eat or sleep properly, can’t pay attention in school, can’t even smile, because of untreated dental disease.

“We don’t agree with everything in the report. But certainly, it highlights some of the major policy areas that the American Dental Association and state dental societies have advocated for years—things like increased Medicaid funding, school sealant programs and community water fluoridation. It also highlights the urgent need for reliable routine data collection so that policies are well-informed and kids are not left suffering.

“The report does omit some policy areas that we believe are equally important to improving children’s access to care. For instance, some states have innovative programs—like student loan forgiveness and tax incentives—to help dentists establish practices in underserved areas or practice in community health centers. And when it comes to fixing Medicaid, money is a huge issue, but it isn’t the only issue. Patients and parents need oral health education to help them take care of themselves and their families to prevent disease. Many of them need additional services, like transportation, in order to be able to get to dental appointments. If Medicaid did a better job of these things, treatment costs would decrease, because we would be preventing more disease and treating less.

“The ADA and state dental societies have a long history as the nation’s leading advocates for oral health. ADA members donated some $2.16 billion in free care to disadvantaged children and adults, both as individuals and through such programs as Give Kids A Smile and Missions of Mercy, in 2007 alone. But we’re the first to admit that we can’t do this alone, and charity is no substitute for an effective, equitable oral health delivery system. We’re grateful for assistance from the Pew Center and others who are willing to lend a hand in what undoubtedly will remain a long, tough fight.”

Give Kids A Smile (GKAS) is the ADA’s major oral health outreach program, launched to encourage parents, health professionals and policymakers to address this important health issue. “We all know that a one-day event is not a delivery system and cannot solve the ongoing problem of untreated dental disease,” stressed ADA President Ronald L. Tankersley, D.D.S. “It is important that policymakers at the federal and state level strengthen dental provisions in public health programs to help put children on the road to good oral health.”

At the various sites, GKAS dental volunteers will provide educational materials, screenings and, where possible, free dental care such as cleanings, X-rays and fillings.

“Although many children will benefit from the services provided through Give Kids A Smile, our concern is for the countless others who continue to suffer from untreated dental disease,” said Dr. Tankersley. “We will continue to advocate for a larger and lasting way, through public policy, to ensure that kids who have been falling through the cracks in our delivery system receive the attention they need.”

The American Dental Association recommends that dental visits begin no later than a child’s first birthday to establish a “dental home.”

Despite everything we know about importance of oral health to overall health, people’s self-esteem and to their employability, state and federal policies continually sell dental care short.

•  Most states spend two percent or less of their Medicaid budgets on dental services.
•  Only 16 states offered substantive coverage for adult Medicaid enrollees in 2007.
•  An estimated 164 million work hours are lost each year due to oral disease.

The American Dental Association is committed to improving the nation’s oral health through public education and through legislative advocacy to strengthen funding for dental services provided through public health programs.
Together, we can work to improve America’s oral health and give all of us something to smile about.

1801—Richard C. Skinner writes the Treatise on the Human Teeth, the first dental book published in America.

  1825—Samuel Stockton begins commercial manufacture of porcelain teeth. His S.S. White Dental Manufacturing Company establishes and dominates the dental supply market throughout the 19th century.

1832—James Snell invents the first reclining dental chair.

1833–1850—The Crawcours (two brothers from France) introduce amalgam filling material in the United States under the name Royal Mineral Succedaneum. The brothers are charlatans whose unscrupulous methods spark the “amalgam wars,” a bitter controversy within the dental profession over the use of amalgam fillings.

1839—The American Journal of Dental Science, the world’s first dental journal, begins publication.

1839—Charles Goodyear invents the vulcanization process for hardening rubber. The resulting Vulcanite, an inexpensive material easily molded to the mouth, makes an excellent base for false teeth, and is soon adopted for use by dentists. In 1864 the molding process for vulcanite dentures is patented, but the dental profession fights the onerous licensing fees for the next twenty-five years.

1840—Horace Hayden and Chapin Harris establish the world’s first dental school, the Baltimore College of Dental Surgery, and originate the Doctor of Dental Surgery (DDS) degree. (The school merges with the University of Maryland School of Dentistry in 1923).

1840—The American Society of Dental Surgeons, the world’s first national dental organization, is founded. (The organization dissolves in 1856.)

1841—Alabama enacts the first dental practice act, regulating dentistry in the United States.

1844—Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice. He conducts the first public demonstration of its use as an anesthetic in 1845 but the demonstration is generally considered a failure after the patient cries out during the operation. In 1846, another dentist (and a student of Wells), William Morton, takes credit for the discovery when he conducts the first successful public demonstration of the use of ether as an anesthesia for surgery. Crawford Long, a physician, later claims he used ether as an anesthetic in an operation as early as 1842, but he did not publish his work.

1855—Robert Arthur originates the cohesive gold foil method allowing dentists to insert gold into a cavity with minimal pressure. The foil is fabricated by annealing, a process of passing gold through a flame making it soft and malleable.

1859—Twenty-six dentists meet in Niagara Falls, New York, and form the American Dental Association. (See the ADA Timeline for more information).

1864— Sanford C. Barnum, develops the rubber dam, a simple device made of a piece of elastic rubber fitted over a tooth by means of weights, which solves the problem of isolating a tooth from the oral cavity.

1866—Lucy Beaman Hobbs graduates from the Ohio College of Dental Surgery, becoming the first woman to earn a dental degree.

1867—The Harvard University Dental School, the first university-affiliated dental institution, is founded. The school calls its degree the Dentariae Medicinae Doctorae (DMD), creating a continuing semantic controversy (DDS vs. DMD).

1869—Dr. Robert Tanner Freeman, graduating from Harvard University Dental School, becomes the first African-American to earn a dental degree.

1871—James B. Morrison patents the first commercially manufactured foot-treadle dental engine. Morrison’s inexpensive, mechanized tool supplies dental burs with enough speed to cut enamel and dentin smoothly and quickly, revolutionizing the practice of dentistry.

1871—The American George F. Green receives a patent for the first electric dental engine, a self-contained motor and handpiece.

1877—The Wilkerson chair, the first pump-type hydraulic dental chair, is introduced.

1880s—The collapsible metal tube revolutionizes toothpaste manufacturing and marketing. Dentifrice had been available only in liquid or powder form, usually made by individual dentists, and sold in bottles, porcelain pots, or paper boxes. Tube toothpaste, in contrast, is mass-produced in factories, mass-marketed, and sold nation-wide. In twenty years, it becomes the norm.

1880—Twenty-eight dental schools are established by this year.

1887—Stowe & Eddy Dental Laboratory, the first successful industrial-type laboratory in the U.S., opens in Boston, marking the ascendancy of the modern commercial dental laboratory. The earliest known dental laboratory in the U.S. was Sutton & Raynor which opened in New York City around 1854.

1890—Ida Gray, the first African-American woman to earn a dental degree, graduates from the University of Michigan School of Dentistry.

1890—Willoughby Miller an American dentist in Germany, notes the microbial basis of dental decay in his book Micro-Organisms of the Human Mouth. This generates an unprecedented interest in oral hygiene and starts a world-wide movement to promote regular toothbrushing and flossing.

1890—Almost 100 dental societies are established by this year.

1895—Wilhelm Roentgen, a German physicist, discovers the x-ray. In 1896 prominent New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.

1899—Edward Hartley Angle classifies the various forms of malocclusion. Credited with making orthodontics a dental specialty, Angle also establishes the first school of orthodontics (Angle School of Orthodontia in St. Louis, 1900), the first orthodontic society (American Society of Orthodontia, 1901), and the first dental specialty journal (American Orthodontist, 1907).

500-1000—During the Early Middle Ages in Europe medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700—A medical text in China mentions the use of “silver paste,” a type of amalgam.

1130-1163—A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade—sharp knives and razors—were useful for surgery. After the edicts, barbers assume the monks’ surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210—A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s—A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

1530—The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth (Artzney Buchlein), the first book devoted entirely to dentistry, is published in Germany. Written for barbers and surgeons who treat the mouth, it covers practical topics such as oral hygiene, tooth extraction, drilling teeth, and placement of gold fillings.

1575—In France Ambrose Pare, known as the Father of Surgery, publishes his Complete Works. This includes practical information about dentistry such as tooth extraction and the treatment of tooth decay and jaw fractures.

Proper nutrition and dental health are indeed intimately linked. Malnutrition has long been linked to common dental health problems, including:

Tooth decay
Gingivitis
Advanced Periodontal Disease
Halitosis
Thus, before focusing on fancy dental health products that are supposedly the new space-aged cure-all for dental health and oral hygiene concerns, it is important to get the basics right. This may be considered to be alternative dental health care by some dentists and medical professionals who tend to focus most education efforts on good oral hygiene practices. However, nutrition is the foundation of dental health and oral hygiene is the complement.

To this end, it is important to focus on fluoride intake. Almost all dental health information released in the past 3 generations points to the importance of fluoride in the prevention of the most common dental problems-cavities.

If you ingest a single milligram of fluoride every day since the day you were born, the odds of having tooth decay decreases by an estimated 50-60%. This is because fluoride is particularly important when teeth are developing because it will literally increase the strength of the tooth and its surrounding enamel as the teeth are mineralizing.

Gingivitis is a term we hear about on TV and in the media all the time. It is actually the most common disease in the world. But what is it? It is an inflammatory process(like arthritis) AND an infectious process (like a staph infection) that causes the gums to lose their normal anatomy and SWELL UP with fluid and excess blood. It comes in three stages:  mild, moderate, or severe. You can see it yourself fairly easily if you look into your own mouth when you have the moderate or severe varieties. It comes from “plaque”. Plaque is a combination of bacteria, food particles, and exfoliated or dead gum cells.

Plaque can be made “worse” by the chemical nature of certain types of food that we eat. Plaque also must be controlled by two methods: what you do at home and visiting the dentist’s office on time.

Either method done alone, or poorly, will automatically lead to tooth loss and dentures. There are basic treatments in the dental office: basic regular cleanings if only minor gingivitis is present, and “deep cleaing gum treatment” if significant gingivitis is present.Significant gingivitis that is left alone or untreated turns into “PERIODINTITIS”. More about that next time. Keep smiling!

“If the crack is small, let’s just leave it alone. It doesn’t hurt and is barely noticeable.” Many patients have uttered those words, only to be back with a big problem at the most inconvenient time. Even though the crack may be small or hardly noticeable it could be a ticking time bomb. Just like a small crack in your windshield that may radiate across at any time. A crack in a tooth may radiate through the nerve or the root, the tooth may need to be removed and replaced, like a car’s windshield. A crown will hold it together and freeze the cracks where they are, permanently. Investing in a crown when the crack is small will help prevent a broken tooth and just may be one of your wisest investments. After a crack has radiated through the nerve or roots, the tooth would require much more time and a lot more money.

Did you know your dental visit could save your life? According to the American Cancer Society, 2 to 4% of cancer diagnosed in the United States occurs in the oral cavity. Each year 30,000 cases of oral cancer are diagnosed, and approximately 8,000 deaths occur. Early diagnosis is believed to be critical to increase survival rate from this deadly disease.

It is our policy at Drs. Kowal and MacIlwaine, to provide a thorough screening for each and every one of our patient’s. Regularly scheduled professional examinations and cleanings, along with an oral cancer screening, just might save your life. Have you had an oral cancer screening lately? Please call to schedule today!