Ask a Dental Health Question

  Lynn Bethel, Department of Public Heath

 

Lynn Bethel is the Director of Oral Health at DPH and a Registered Dental Hygienist

Your dental health is an important part of your overall body health. It’s necessary to take good care of your teeth and gums to prevent cavities and gum disease; however, maintaining dental health isn’t always easy.  Many dental health topics and messages can be confusing.

This ‘Ask the Dental Hygienist (RDH)’ blog is a resource for you to ask dental health questions and get answers directly from a licensed dental professional. Your questions will answered by a RDH within 2 business days. Even if you don’t want to submit a question, you can learn from others’ questions, and topics/answers posted by the RDH.  But remember, the answers in this blog don't substitute for regular visits with a dentist and dental hygienist. 

Visit ‘Ask the Dental Hygienist’ often, and remember: all submitted questions and RDH answers will be publically posted on the blog.

Comments

[Louise]

My 19 year old fractured both front teeth as a 10 year old. Now they are frail, and breaking, they are bonded and it's deteriorating. We have Masshealth because I'm unemployed and she's in college. She needs IMPLANTS, what do we do? where do we go? How can we pay????? What is covered? Help!!!

Dear Louise: Any MassHealth member under 21 years of age is covered by the comprehensive dental benefits that the state provides. So, the good news is your daughter does have dental coverage! Unfortunately, MassHealth, like most commercial insurance plans, does not cover implants. Our recommendation is to seek out a dentist that accepts MassHealth reimbursement and learn about the dental treatment options that your daughter does have and go from there. You can find a MassHealth dental provider through the "MassHealth Portal" at this site: http://masshealth-dental.net/MemberServices/FindProvider.aspx

Our best to your daughter in her college studies!

[janice]

hi..my front six or so teeth are so loose i can move them with my finger,,i am afraid one of these days one or more is going to twist the wrong way and either fall out or need to be pulled,,i am on masshealth and social security disability...i have been going to an oral center in taunton...i go because i have no other choice...dentists supposedly take masshealth but if you call the doctors on the list we received , most do not or they only take young children,,my question is does masshealth cover getting dentures if necessary ? and all that entails, meaning removing remaining teeth ,etc ?

Janice...thanks for your question. First and foremost, if you have teeth that are loose and move you should see a dentist to have the situation evaluated and to understand your options. It would also be important to find out if you have any oral infections surrounding the teeth and if you need an antibiotic.

Currently, for anyone 21 years of age and older, MassHealth covers dental examinations, x-rays, preventive services like cleanings, as well as extractions (removing teeth). They do not cover the replacement of teeth with dentures or partial dentures. With that said, many of the state's health centers with dental programs are able to assist MassHealth members receive some dental procedures through the Health Safety Net payment system. These would be procedures that are currently not paid for by MassHealth. For a list of these dental programs go to: http://www.mass.gov/eohhs/provider/client-eligibility/health-safety-net/for-patients.html

Let us know if you need further assistance...

[Tyler Stokes]

About 4 years ago I got crowns and veneers on my front teeth. Recently I started kick boxing training and was very hesitant to do any sparring because I'm scared I may injure my teeth. What are the chances that veneers or crowns can be damaged while wearing a mouth guard?

Tyler...It's great that you are wearing a mouthguard. Did you know that an athlete is 60 times more likely to suffer harm to their teeth when not wearing a mouthguard?

Mouthguards help to buffer an impact or blow that otherwise could cause broken teeth, jaw injuries or cuts to the soft tissues. There are three types of mouthguards: 1. Ready-made, that you might purchase at a sporting goods store; 2. Boil and bite, which you could form to your teeth at home; and 3. Custom-made. The third option is made specifically for your mouth by a dental professional and it offers superior protection.

Even if you cuurently have a custom-made mouthguard, we would recommend that you visit your dental professional to be sure it's fitting properly to gain the most benefit and protection.

[Frank]

Hi, I've been trying to find a direct answer to this question: I need reconstructive jaw surgery; double jaw to be exact. Both of my condyles are completely damaged and due to that, I my jaw is so far back that it disturbs my sleeping habits. I have school insurance but it seems they won't cover the surgery because it's from a college and it seems like the bare minimum. On top of that, I have health safety net partial and I am seeing a doctor at MGH and he is not a private oral Maxiollfacial surgeon. He has said it is a medically necessity. Would I have any problems with the health safety net covering the cost of the surgery?

Hi Frank- Have you had an opportunity to speak with patient services at MGH? They are quite helpful in determining benefits and making the necessary phone calls to get prior approvals and estimates of cost. A second recommendation is to contact the Health Safety Net directly. You can find useful information on their website at: http://www.mass.gov/eohhs/provider/client-eligibility/health-safety-net/for-patients.html and their phone number is 877-910-2100.

[C Souther]

What is a parent to do when Masshealth coverage stops after braces have been put on the child and now the mom has a job with insurance? I don't think it's fair that the dentist won't work with the mom on the payments and if she goes to any other dentist they want full payment for the braces when they didn't even put them on? They did suggest that they remove the child's braces and start all over again? What I don't understand is if the dentist was being paid say $75.00 a visit and the mom is willing to pay more but not the full price why they won't take it? Can a dentist refuse to give care because a child already has braces on? The dentist my grandchild was seeing in not in network with her new insurance so they want full payment?

Thanks for your question. I can understand your frustration and concern for your grandchild. Have you spoken to anyone within the MassHealth Dental Program? I am sure that this is not the first time something like this has happened and there may be a protocol in place to cover this situation. Feel free to contact my office and we'll get you to correct person to get some clarification.

[Sonic Toothbrush Reviews]

I enjoy your blog so wanted to come check out this post. You sure bring in some interesting tips. Would never have thought to relate my blog. Sharing personal stories does make for a more interesting post and I have found even as a newbie to blogging that is how I seem to be connecting with my visitors and other members of the blogging community.

[kayla]

I my names Kayla I am from worcester Ma & I am a member of Bmc Commonwealth care plan type 1 which I just found out covers dental extractions which I also just found out I need all my widome teeth out & I am extremely fearfull of the dentist & I finally found a dentist I am comfortable with who accepts dentaquest through commonwealth care. My Problem is I am unemployed now ?& just filled out my anual review form for bmc & just recently found out I may be forced to switch to network health under the medical security plan bc I am unemployed ,network health told me there is no dental coverage & I a very low income I can not affoed the extractions or the general anasthsia out of pocket what can?should I do to try to have my extraction taken care of ?

Thanks for the question, Kayla. A change of insurance can be confusing and very frustrating, epecially if it holds off needed treatment. There are two community health center dental programs in Worcester, Edward M. Kennedy Community Health Center and Family Health Center of Worcester; both can provide you with a consultation concerning your wisdom tooth removal. They also offer a sliding fee scale, which depending upon your income, will determine your cost outside of what is covered by your medical/dental insurance.

[claudiarlanglois@gmail.com]

Hi - I am 60 years old and lost my job at National Grid in May of 2011. I collect unemployment and have state insurance but there is no dental insurance. I have no money and already have a payment plan with carecredit and still owe $1000 so I cannot get more credit. I went for a free dental consultation today at Aspen Dental - 14 cavaties, need gum scraping; have gum infection and need two teeth pulled and have been in pain for months - I can only eat soft food. The estimate to get my teeth fixed is over $6,500. I had a cancer check today because the dentist noticed a white spot - Thank God it was not cancer but just that cost me $79. I have no one to co-sign me or give me money and I don't know what to do - can you assist me at all? Thank you so much! Sincerely, Claudia

Hi Claudia...thanks for your email. We're sorry you're experiencing troubles with your dental health. Massachusetts is fortunate to have three dental schools, seven dental hygiene schools and many community health center dental programs that offer reduced cost dental care. You don't say where you live in the state; and while the dental schools are all located in Boston, the dental hygiene schools and the community health centers are located statewide. On our website you can access a directory of the community health center dental programs and for a listing of the dental hygiene schools, please feel free to email the Office of Oral Health at Oral.Health@state.ma.us

We hope this is helpful!

[rahul]

Wish the latinos had access to care on online sites. . .even wedmd.com they can't access but only a few sites like www.heatlhsouk.com they can access in Spanish for affordable health care and dental care, and we need more discounted dental care and insurance nationwide. . .I know I pay via cash and not with insurance so I need cheaper health service access. . .A lot of my immigrant friends don't speak Spanish though. . .that's a problem with a lot of these sites.healthsouk.com

Dear Rahul... We agree, it is important to have not just dental information, but all health information available in different languages. Most of the dental fact sheets located on our website are available in Spanish, as well as other languages...feel free to send us an email and we can send you any of those documents. We are also fortunate to have more than 50 community health centers throughout the state that offer culturally responsive dental care. On our website is a Directory that lists what languages, other than English, are spoken at each site. Thank you for your email.

[Emery Chernan]

Hi Lynn,

Just a quick comment. So many of us visit our dentist with out fully understanding what causes our dental problems. From my own personal experience, dentists along with other professionals will not give you the right answers unless you ask the right questions.
This is why it's so important to have educational sites like yours' to help prepare us for our next dentist visit. Thank You.

Good we can help... :-)

[Barry Livingstone]

I see this post is a few years old but I’m hoping that you are still taking questions about dental health. I think what you are doing here is a fantastic idea & very helpful.
Now, my question is. When buying toothpaste, do we need to buy an expensive, reputable brand of toothpaste?
I’ve often wondered if the cheap brands of toothpaste are just as effective as the more expensive brands such as Coalgate. Personally, I always buy the more expensive brands but the cost of living just seems to be increasing at an alarming rate. It would great if I knew whether or not the cheaper brands are just as good because they are around half the price compared to popular, expensive brands. Thanks :-)

Dear Barry: When it comes to toothpaste, you want to be sure that you are using one that has fluoride. Cost doesn't matter...fluoride does! If you are interested in saving money, consider how much toothpaste you are using to brush with each morning and night. Most advertising for toothpaste show the brush with a perfect "ribbon" of paste...that is too, too much! The actual recommendation for those over the age of two (that includes adults) is to use just a pea-size amount of fluoride toothpaste. For children two and under, just a smear of fluoride toothpaste should be used.

Also, please remember that you should ALWAYS use a SOFT-bristled toothbrush. Using anything but a soft-bristled brush will damage your gums and teeth.

We have a fact sheet with pictures of the right amount of toothpaste to be used, how to brush and information on replacing toothbrushes available on our website at www.mass.gov/dph/oralhealth under topic area "fact sheets and resources". Thanks for your question. :-)

[Val]

Many people seem not to care too much about their dental health. I used to be one of them. Now as I age I care more. So I was wondering if you could give us some advice about electric toothbrushes. Are they recommended or are they not worth the cost? Any advice would be appreciated.

Dear Val

Congratulations on your dental health conversion! Oral health is VERY important, not just for being able to eat and speak, but it can actually affect self-esteem and employability. More and more credible research points to the impact poor dental health has on systemic health. Did you know that someone living with diabetes and who has poor dental health will have a harder time controlling their blood sugar? Did you know that seniors with poor oral/dental health have an increased chance of bacterial pneumonia? With that said, good oral hygiene and the effective removal of plaque bacteria from the teeth and gums is very important. Powered toothbrushes have experienced many changes over the years. Some "power brushes" are battery operated and some are actually disposable. Are these toothbrushes recommended for everyone? While they are especially effective for someone who has a disability, such as limited motion or limited strength in their arm/hand, they are not necessary for the average individual to effectively and efficiently clean their own mouth. Effective tooth brushing, with both the power brush and a manual toothbrush, entails the bristles of the brush being placed at a 45 degree angle where the tooth and gum meet, then brushing in a circular motion. Be sure to ALWAYS use a soft bristled toothbrush and fluoride toothpaste. For more detailed information on toothbrushing check out the fact sheet on our website titled, "Preventing Tooth Decay and Toothbrushing" at www.mass.gov/dph/oralhealth. Search under topic area, "Fact Sheets and Resources".

[Jen]

I was wondering if surgically taking out wisdom teeth will make my tinnitus louder?
I have to take them out but I'm really really scared that it will make my tinnitus louder.

Dear Jen: It's understandable that you are nervous. Any type of surgery has its risks and its good that you are asking questions to be as informed as possible. The best person to answer questions about the surgery and its outcome is the individual performing your surgery and perhaps your ENT and/or your primary care physician. Wishing you well...

[Bob]

does masshealth essential pay for all the extractions I would need before dentures.I realize they won't pay for the dentures

Hi Bob...MassHealth currently reimburses for extractions for members 21 years of age and older. If you want more information on your MassHealth dental benefits, please go to: http://masshealth-dental.net/MemberServices/Default.aspx

[Kathy]

Hi,
Is it mandatory in Massachusetts that a dental assistant register with the state?

Thank you.

Hi Kathy. At this point, dental assistants to not have to register with the Board of Registration in Dentistry (BORID), though that will be changing soon. A law passed in early 2009 that does require all dental assistants to register with the BORID. The regulations that support this law will be open for public comment. To find updates on the registration process, frequently visit www.mass.gov/dph/boards/dn for announcements and other information.

[Sylvia]

Hi, I had a question about HSN dental coverage. My mom has Commonwealth care plan type 2 (so no dental coverage) but she does have HSN Dental available. She has been having dental pain and the dentist said she had pretty severe gingavitis and would require multiple visits to possibly fix it. I was wondering if HSN dental would cover those visits? or would we have to pay out of pocket? Thanks!

Hi Sylvia: The Health Safety Net(HSN) will pay for medically/dentally necessary services that are on the list of MassHealth Standard covered services, as long as the services are provided by Massachusetts community health centers (CHC) or hospitals. For adults MassHealth continues to cover some preventive services, such as dental cleanings. Your mom would need to have an examination by a dentist at one of these facilities to determine her dental treatment needs and to find out what would be covered by the HSN. The CHCs also offer sliding fee scales for non-covered dental services at a lower cost or no cost, depending upon your mom's income.

You may access a list of community health center dental programs on our website at www.mass.gov/dph/oralhealth Search under "Fact Sheets and Resources"; in the middle of the page there is a Directory that lists the CHCs by County.

[katrina]

I have recently been approved for MassHealth Essential. I have a tooth that may need extraction and a dental implant. Am I covered by Mass Health for the dental implant if I go to a Community Health Center provider?
Katrina

Hi Katrina- The tooth extraction is a covered benefit for MassHealth members, but implants are not a covered service.

[RS]

How do I get copies of my dental records and will it cost me money to retrieve them?

Thank you for your question, RS! The Rules and Regulations (RR) for the practice of dentistry in our state are very clear concerning the request of dental records.

According to the RR, "A copy of the patient record, including radiographs, shall be provided within a reasonable amount of time not to exceed 30 calendar days from the date of the request. The licensee may charge a reasonable fee for the expense of providing a patient's dental record, not to exceed the cost of either labor and/or materials incurred in the copying of the patient record, radiographs and models. The licensee shall not require payment for dental services rendered as a condition of providing a copy of the dental record. A dentist may offer to provide the patient with a summary of the patient's record, but the summary shall not be in lieu of the complete patient record if requested."

You may be required by the dental office to provide a written request for your records. If you have further questions, we'd suggest that you contact the Board of Registration in Dentistry at 617-973-0971.

[Nathan Abraham]

I have a tooth that was broken off just below the gum line- a dentist said that it will need Oral Surgery to have the rest of it removed.
I have Health Safety Net and would like to know if this will be covered by HSN?
Thanks
Nathan

Thanks for your question, Nathan. The Health Safety Net will pay for medically necessary services that are on the list of MassHealth Standard covered services, as long as the services are provided by Massachusetts community health centers (CHC) or hospitals. MassHealth does cover the extraction of teeth; though, we recommend you speak with the community health center first. For a listing of community health centers with dental programs in Massachusetts go to www.mass.gov/dph/oralhealth and search under topic area "Fact Sheets and Resources". On that page you will find a directory of CHCs by County. For more information about the Health Safety Net and its covered benefits go to www.massresources.org/hsn.html

Good Luck!

[Fort Pierce Dentist]

Great information and we appreciate the posts. Please keep them coming. SJ

[Lisa Goyette]

Hi Lynn,
I live in Massachusetts, not sure how much you know about mass health. BUT as of this past March (I beleive it was march) Mass health stopped paying for patients over 21 for dental work other than cleanings. Now what do i do? Im 40 years old, stay home mom and my teeth I feel are very sensitive and I believe I have some gum line issues, maybe some small cavities, and I know I cant wait long because Im getting older and my teeth are getting worse. I take great care of my teeth, but must be genetic because both my parents have dentures due to decayed teeth for many years. I know back then dental coverage wasnt always readily available or affordable. So now that Mass Health has stopped any dental work, before my teeth start falling out what can I do? I wish they didnt stop that coverage because now Im going to need LOTS of work done by the time I figure thisout. I dont have any money because Im a stay home mom. My dentist already told me it would be over 1600 dollars to fix what he has seen so far, so Im sure its higher than that now. I just dont have that kind of money, do you have ANY suggestions?

Dear Ms. Goyette

Thank you for your question. You are to be commended for being proactive about your dental health. You are not alone in your concern over where to find restorative dental care as a MassHealth member. As of July 2010, MassHealth dental benefits for members 21 years of age and older were limited to preventive services, exams, cleanings, and x-rays, as well as extractions. Though, if a MassHealth member 21 years and older receives their dental care at one of the 50 community health center dental programs in the state, they are also eligible to receive fillings, dentures, etc. as a benefit as long as the tooth that is receiving the care is eligible. To find a community health center dental program most convenient for you, there is a directory on our website, www.mass.gov/dph/oralhealth Please look under topic area "Fact Sheets and Resources". You can also contact the Office of Oral Health directly if you have additional questions.

[Michele]

My son is on Mass Health as he is on SSI. He has been for a very long time. He had to go to the Dentist and they had to do an extraction and fillings. Can you tell me if they are covered as they are milking us big time and I dont feel this is right to charge some one on SSI hundreds of dollars for something that may be covered by his Mass Health....

Hi Michele...thank you for your email. For any MassHealth member 0 to 21 years of age, comprehensive dental care (exams, cleanings, fillings, extractions, etc) is a covered benefit. For those members 21 years of age and older, the dental benefits are limited to exams, cleanings, x-rays, and extractions. There is a caveat...if a MassHealth member 21 years and older receives their dental care at one of the 50 community health center dental programs in the state, they may also receive fillings, dentures, etc. as a benefit as long as the tooth that is receiving the care is eligible. Please contact the Office of Oral Health directly, if you need clarification or additional information.

[Pete Morris]

Hi there, Thanks very much for the opportunity to ask questions. I'd like to ask about the safety of mercury fillings. I recently read several articles linking things such as depression and stomach problems to mercury fillings. The reason I ask, is that my mom has a lot of mercury fillings in her mouth, and does indeed suffer from stomach problems and occassional depression. I know the general dental consensus is that they are safe, but is there any open-mindedness or attempts to investigate these claims in the dental community? Many thanks

Dear Mr. Morris

We can appreciate your concerns, but also want to reassure you that amalgam fillings are safe. Amalgam restorations, commonly called silver fillings, have been used by dentists for more than 100 years and are the most thoroughly researched and tested filling material among that is used today. These fillings do contain small amounts of mercury, but are combined with other metals to stablize the mercury and make it safe.

Many reputable science-based agencies and organizations have done studies on amalgam (silver) fillings. Their findings demonstrate that for an individual with no mercury allergy, there is no association between exposure to amalgam and adverse health effects.

[joel smith]

hi my name is joel i have one question. my mouth is absessed and i need a tooth extraxcion. i just lost my job over a month ago and im waiting for the unemployment health security thing.i have no money to do anything but my mouth is really hurting bad like a 7 on a scale of 1 to ten.i live in gloucester ma please what am i suppose to do .i called a couple dentists but i dont have a 1000 dollars to get it out help.

Dear Mr. Smith

Massachusetts has more than 50 community health center dental programs located statewide. These dental programs provide comprehensive dental care, including extractions, at no-cost or low cost, depending on your income. You can access a directory of these dental programs on our website at www.mass.gov/dph/oralhealth (look under topic area "fact sheets and resources"). Within the directory, the health center dental programs are organized by County. If you need further assistance, please consider contacting the Office of Oral Health at Oral.Health@state.ma.us

[Doylestown Teeth Whitening]

Thanks for sharing your ideas and thoughts, i like your blog and bookmark this blog for further use thanks again…

[Raymond P. Bilodeau]

Your response to the question about MassHealth is wrong. MassHealth will no longer pay for anything but extraction and cleaning. Your response puts your credibility in serious doubt.

I can assure you from my personal experience.

[Vanessa hampton]

Please advice as to dentist near Ware, Massachuetts that treat TMJ with electro threapeutic stimulation and or front customized mouth orthotic.

Our best suggestion would be for you to contact the Massachusetts Dental Society (MDS). MDS publishes a directory of their member dentists by location, as well as specialty. You can access the Dental Society via their website at www.massdental.org Good Luck!

[Emma]

If dental care is such an important part of over all health care for people of all ages to deny anything but teeth extractions to low income and disabled people over 21 through Mass Health is in my opinion is a a terrible way to go. Doesn't anyone care about these people? I am not sure what you can suggest to people over 21 who are not getting the care they need from Mass Health Dental.

Dear Emma

Thank you for your comment. You are correct, oral health is important for overall health and wellness at any age; and obtaining regular preventive care is key to ensuring a lifetime of healthy smiles. What you may not know is that oral health preventive services (exams, cleanings and x-rays) are a covered service for all MassHealth members 21 years of age and older. If you need more information on what dental services are covered by MassHealth for those members 21 years of age and older go to: http://masshealth-dental.net/MemberServices/Default.aspx

[Nik Sakulus]

Hi Lynn,

Is there any medical conditions that would prohibit/need to have special arrangements a child from participitaing in the toothbrushing programme ?

Hi Nik...thanks for your question. In January 2009, Massachusetts began requiring daily toothbrushing in licensed daycare facilities and school settings serving preschool-age children.

Because toothbrushes are used in the mouth, they do have bacteria and there is a small chance that the toothbrush could become contaminated with blood during brushing. Although the risk for disease transmission through toothbrushes is minimal, it could be a potential cause for concern if someone is chronically ill or severly immuno-depressed. In response, the Office of Oral Health has developed a guidance, "Growing Healthy Smiles in the Child Care Setting" for child care providers. This guidance provides information on how to implement a classroom toothbrushing program, and it includes information on clean-up, infection control and proper storage guidelines according the Centers for Disease Control and Prevention (CDC) guidelines to limit the transmission and cross-contamination between children.

You can read the Department's guidance at: www.mass.gov/dph/oralhealth (topic area "Fact Sheets and Resources") and the CDC's guidelines at: www.cdc.gov/OralHealth/infectioncontrol/factsheets/toothbrushes.htm#schools

[Ben McKelway]

Are dental x-rays required by law? If so, does the law specify a maximum interval between x-rays?

Thanks for your question... The American Dental Association (ADA) issues updates and recommendations on a variety of dental topics, including dental radiographs (xrays), based on the most recent scientific evidence.

Historically, dentists have prescribed regular x-ray examinations for patients on a schedule. The ADA's recommendations now advise that dentists carefully evaluate the benefit of x-ray exposure for each patient. These recommendations are also supported by the Food and Drug Administration (FDA), and state that dentists should prescribe radiographs after an evaluation of the patient's needs that includes a health history review, a clinical dental history assessment, a clinical examination and an evaluation of susceptibility to dental diseases.

The Massachusetts Board of Registration in Dentistry is responsible for licensing dentists and dental hygienists for practice in the Commonwealth, establishing rules, regulations and policies governing the practice of dentistry, including dental x-rays. I recommend you contact the Board with your specific questions and concerns at 617-973-0971 or by email at dentistry.admin@state.ma.us

[sandra moreschi]

do you have a list of dentist that take mass health ?

Hi Sandra

The Executive Office of Health and Human Services publishes an online resource with the names and addresses of dentists that accept MassHealth. The resource also distinguishes dental providers by specialty, and includes a listing of public health dental hygienists. To access this resource, please go to:

http://masshealth-dental.net/MemberServices/FindProvider.aspx

[Amber]

Hi, I had leukemia treatment 13 years ago which has resulted (amongst other things) in my having a permanent dry mouth condition. I've had a multitude of cavities because of this, and during a recent half year of extreme stress, I developed significant periodontal disease. I had non-surgical treatment for it, and my dentist told me last month that I no longer have any gum pockets and very little plaque(hooray!). Since the three-month long periodontal disease treatment (ouch!), I have been maintaining my teeth with a 35-40 minute session every night, in which I floss, brush with inter-dental brushes, and use a high-quality electric toothbrush for 16-20 minutes. My question is, am I brushing too much? I am under the impression that I do not have any enamel left (is that possible?), but I am very worried about keeping my own teeth (I'm only 33). Is my tooth routine too extreme?

Amber: Your dedication to your oral health is to be commended! Many times in the past, we have written on the devastating impact that dry mouth (xerostomia) has to the teeth and other oral structures.

While we can't make a judgment on whether or not your teeth cleaning routine is damaging your enamel, we can offer some general tips...1. Always use a soft bristled toothbrush.; 2. When using an electric toothbrush, be sure you don't use extreme pressure.; 3. The average person should be toothbrushing for at least two minutes at each session. Most electric toothbrushes have internal timers that signal (about every 30 seconds) when the user should move to a different area or quadrant of the mouth.; 4. Drink fluoridated water and use a fluoride toothpaste to prevent new tooth decay; 5. Chew sugarless gum with xylitol added to help produce saliva which will also help to self-cleanse the mouth and serve as a buffer to inhibit the bacteria that causes tooth decay.; and 6. Consult with your dental professional on an appropriate preventive routine for you to ensure that you are on the right track for keeping your mouth and teeth healthy for a lifetime. Good Luck!

[Dr. Green Coral Springs Dentist]

Thanks alot for the post and for your service. The importance of dental health cannot be overemphasized!

[Dental Assistant Salary]

i like the post a lot...please suggest me some good dental hygienist near Singapore...and i also want to know some tips about pets oral health... please give me some suggestions related to pets oral health...how can we prevent them from harmful disease???

While I can’t make specific recommendations on dental hygienists in Singapore, I did find a government sponsored website which includes a search engine for dental hygienists practicing in Singapore. http://www.sdc.gov.sg/html/1192418881418.html

As for “Fido” and “Tiger”…just as research has demonstrated that poor oral health can impact a human being’s physical health and wellness, science is also demonstrating that our furry friends’ dental health is important for their general health, as well. Did you know that about 80 percent of dogs and 70 percent of cats show signs of oral disease by age two?

To maintain good oral health for your pet, brush their teeth every day with toothpaste made especially for pets, and talk with a veterinarian about your pet’s dental needs. Also, check out the American Veterinarian Medical Association's website for videos demonstrating appropriate oral care for your pet.

[Dental Hygiene Continuing Education]

hi....i like your blog a lot..I was wondering to know how many times in a year we should visit our dentist?? and what precaution we should use for kids dental health as they fond of sweets and chocolates??

Thanks for your question… Historically, the emphasis on dental care has been treatment focused…fixing cavities and removing teeth. With the advent of community water fluoridation in the 1950’s, coupled with the availability of fluoride toothpaste and dental sealants example, the predominance of dental care is now focused on prevention.

While accessing regular preventive care (check-ups and cleanings) is very important and will help to identify problems early; there is no set guideline as to how often an individual should visit a licensed dental provider. This is because each person is different and their dental needs may vary and will most likely change during their lifetime. The best way to decide is to talk to your dentist and dental hygienist, become aware of your individual dental needs. and formulate a schedule together to maintain your dental health. Good Luck!

[Judith Rogers]

I retired from the District court house. when i retired i dropped my dental insurance. Is it true that you can't get it back once you drop it?

Dear Ms. Rogers...rules concerning enrollment are different for each employer/insurance company; and our best recommendation would be for you to contact your former employer's retirement liaison to find out what your current eligibility is for employer sponsored dental insurance. Good Luck and Happy New Year!

[Catherine Moore]

You mention that there are over 500 medications that reduce salivary flow, and medications for heart disease and epilepsy that cause gum inflamation and overgrowth. Where can I find a list of these medications and which effect they cause?

Thank you for the question, Ms. Moore. The most common categories of medications that cause xerostomia (dry mouth) are antihistamines, antidepressants, anticholinergics, anorexiants, antihypertensives, antipsychotics, anti-Parkinson agents, diuretics and sedatives. Other drug classes that commonly cause dry mouth include antiemetics, antianxiety agents, decongestants, analgesics, antidiarrheals, bronchodilators and skeletal muscle relaxants. We would recommend you consult with your local pharmacist to determine the side-effects of specific medications.

[Jon Darlington]

Hi Lynn, I would just like to say I have really enjoyed reading your blog. Your advice is really good and honest.
I just wanted to make a comment on a point made regarding the validity in information in this kind of environment. As you say you cannot make online diagnosis but you can give valuable advice. I think the difference between getting slightly dubious advice from a random source and getting advice from a qualified professional is the key here. Your website is a government website and you are obviously highly qualified - therefore it is quality advice.
I also think that people don't ever see this as a replacement to going to the dentist as nobody is going to be performing their own dental treatment.
I think it is a great opportunity to get good advice. Thanks

[Pearl White]

I am confused, how often should anyone visit a dental hygienist?

Dear Ms.White: My short answer-there is no cookie cutter schedule... each person's needs are different, with or without natural teeth. While receiving REGULAR dental care including examinations, oral cancer screenings, cleanings and professionally applied topical fluoride treatments is critical for the prevention and early diagnosis of oral/dental diseases; the schedule for receiving these services should be based on the individual's oral/dental health, which may change over their lifetime.

[Mass Unemployed]

I have been unemployed for several months now. I am married and have a child, I receive health insurance through the Medical Security Plan related with Unemployment Insurance. I am in desperate need of the extraction of my wisdom teeth. I tried to go to an oral surgeon to get them out but unfortunately my insurance plan doesn't even cover impacted wisdom teeth. The surgery would cost between $1500-2500 to remove 2-4 wisdom teeth. Being out of work, I don't have that kind of money to spare. What other resources can I use to get my painful wisdom teeth taken care of?

Dear Mass Unemployed...We're sorry to hear that you are experiencing dental pain. Though you don't mention what part of the state you live in, Massachusetts is fortunate to have a network of community health center dental programs statewide that provide dental care, and they use a sliding fee scale for payment. You can access a listing of these dental programs on the Office of Oral Health website [www.mass.gov/dph/oralhealth] Look under topic area "Fact Sheets and Resources".

Massachusetts also has three dental schools, all located in Boston, that provide lower cost dental care, including the removal of third molars (wisdom teeth). If you need further information for accessing these resources, you can contact the Office of Oral Health directly at oral.health@state.ma.us

[Laura Chattington]

Hi Lynn,
I have been reading your blog and it is a great place for people to discuss dental health issues and improve our awareness.
I would be interested in your view on how far can dentist help patients remotely - like on a blog - and is there any risk of patient's wrong diagnosis.
I guess I'm interested on where you might want to draw the line?
Personally I think it is a great way of getting doctors engaged with their patients through channels that are open and breaks down some of the walls that have been built in the traditional dental service sense.
I look forward to hearing from your experience with this blog.
Best wishes,
Laura Chattington

Dear Laura: Good to hear you're following our blog and that it has been useful. Blogs are a great resource to expand the followers' knowledge and they serve as a foundation for the exchange of information. We can't comment on the vailidy of online diagnosis', the recommendation of treatment or potential inaccuracies, not knowing the mechanism of aquiring the information via the internet and the professional expertise reviewing it.

The purpose of "Ask a Dental Health Question" is to serve as a resource for oral health information. It does not substitute for a dental examination/assessment by a dental professional. Thanks for your question.

[Courtney]

I've been a medical assistant for several years and am considering going to school to become a dental hygienist. Of course all the schools (in my area near St.Louis) make it out to be a dream job with great pay and flexibility. What aren't they telling me? Thanks for any advise.

Dear Courtney. Thanks for your email. I have been a licensed dental hygienist for close to 30 years and have never regretted my choice of career. The dental hygiene profession is very diverse and includes employment opportunities in clinical practice, marketing/business, education, research, management and public health.

Dental hygienists are the prevention specialist within the dental team; and play a key role in educating individuals on the relationship between oral health and general health/wellness. Good oral health isn't about white teeth, but rather its related to the ability to eat healthy, nutritious foods, communication, employability and controlling chronic illnesses such as cardiovascular disease and diabetes. My advice would be to consider your "dream CAREER" based on the positive impact you can make on someone else, rather than solely on the flexibiity and payscale it can provide to you. For more information on the dental hygiene profession and education go to www.adha.org and http://www.explorehealthcareers.org/en/Career.2.aspx

Good Luck!

[Sarah Hines]

About 2 years ago, while I was in college and I was on Christmas break 2008, I had a root canal procedure in the molar identified as #15. After the procedure, my dentist measured the tooth for the crown and then placed a temporary crown over the shaved tooth. I was supposed to receive the permanent crown, in a month when I return home on another break but the permanent one fell out. The dentist had to shave the tooth down more & also replace two orange rubbery fillings that came out. Two months later, I went back to my dentist to have the permanent crown fitted. When the dentist attempted to put the crown on, it didn't fit properly. Two months later (it's now summer time, I've graduated from college, and now I am home), I go to the dentist to have the new permanent crown placed. The process is finally completed. Fast Forward to now, 1 &1/2 years later. M In the past three weeks, I experienced a massive amount of pain in the molar where the canal was performed. It started as a a constant throbbing pain all over the head and even in my chest. I had a fever the first day this occurred. Some days the pain goes away but still hurts when pressured is applied. Some days I experience the throbbing pain again. I can't eat on those days or even speak. I take advil but it doesn't always work. A few nights I have been unable to sleep. It seem laying down only makes the pain worse. I went to another Dentist at NYU School of Dentistry. The students and the professor say an infection is in the canal.

I went back to my Dentist so that he too could take an x-ray. The infection was there when he first performed the root canal. But other x-rays show the infection remained even after the root canal was performed. I’m pretty sure it was supposed to be removed during the procedure. I am also pretty sure he was aware it remained but did nothing about it because he wanted me to continue to come so that he could make money off my insurance. When I returned to him yesterday to get xrays, he gave me a prescription for antibiotics & removed my crown so that it will relieve the pressure (“your infection presses down on the tooth as your bottom teeth force the teeth up.”) The crown is damamged and cannot be placed back on.

I now have no insurance. I have two deep cavities that must be filled. NYU will charge me $700 to retreat the canal. I have no clue how much the new crown will cost. The fillings at NYU may cost $120 each. (Also, one of the cavities was already filled by my dentist in 2009 and fell out during Summer 2010). I don’t trust my dentist. Also we will probably charge way more. I asked him several times for an estimate concerning the fillings and he consistently attempted to beat around the bush. He also said he may need to perform a root canal on the tooth where the filling came out. NYU said the the cavity is deep but a root canal is not necessary.

I have decided to have both fillings done.

Now that I have antibiotics, I am considering just having the tooth measured for a new crown without having the root canal procedure redone.

What should I do?

Dear Ms. Hines...While we're very sorry that you are experiencing dental pain and can sympathize with your confusion concerning which dental treatment to choose, we can not provide specific recommendations regarding treatment. What we can suggest is to get a third opinon, a completely independent review of your past dental history, current x-rays, etc., to help you decide what the best course of action is to treat your dental infection for your optimal oral health.

[JAck-Worcester]

what damage if any can a tootsie roll do to a child's enamel? are the dangers from tootsie roll different than other candy?

Tooth decay doesn't occur over night, it occurs due to repeated attacks by bacterial acid. In the simplest form, the "chain of decay" occurs when dental plaque (bacteria) mixes with dietary sugars (candy, for example) to form acid (lower pH in the mouth) which demineralizes the tooth's outer surface (the enamel). On average, the low pH remains for about 20 minutes before returning to neutral levels. These repeated "acid attacks" over a period of time is what causes tooth decay. A dietary sugar that is sticky, such as taffy, caramels and even tootsie rolls, will remain on the tooth surface longer than other dietary sugars increasing the length of exposure to the tooth surface by the acids. What is important to remember is the tooth structure is "living." The enamel can be regularly remineralized by increasing protective factors such as limiting dietary sugars, frequently brushing with a fluoride toothpaste, and drinking fluoridated water.

[Maria Alonzo]

Hi. I'm a foreign trained Dentist with a couple of years of experience and I'm currently applying to an Advance Standing Program in BU/Tufts in order to be able to practice as a Dentist in Boston in the near future. However, in the meanwhile, I would like to apply for a dental hygienist license to gain more work experience and learn the dynamics of the profession here. Could you please explain me what steps I need to take to get the DH license? What about the limited dental registration process, how does it work? Thanks so much for your help.

Dear Ms. Alonzo-The Massachusetts Board of Registration in Dentistry is responsible for the licensure of dentists, including limited license dentists, as well as dental hygienists. The rules and regulations that govern the practice of dentistry are detailed concerning the licensure of all dental professionals. In addition, the Board has a dedicated webpage with information on the limited license dentist category. To access the rules and regulations, as well as other useful information about licensure go to www.mass.gov/dph/boards/dn

[Rona Cronin]

where, on line, would I find if there are any complaints against a Dentist/

The Massachusetts Board of Registration in Dentistry is responsible for the licensure of both dentists and dental hygienists in the Commonwealth. You can "check a license" of a dental professional on the Boards website...www.mass.gov/dph/boards/dn or by telephone-617-973-0971.

[dentist roseville ca]

What are some of the service maybe given by a dental hygienist? Thanks for the reply.

A dental hygienist may provide dental services which are educational, therapeutic, prophylactic and preventive in nature that are authorized by the Board of Registration in Dentistry (Board). They may also perform all tasks performed by a dental assistant under the specific type of supervision, also determined by the Board. A dental hygienist or public health dental hygienist may not perform acts or services which require diagnosis and treatment planning for non-dental hygiene services, surgical or cutting procedures on hard or soft tissue, and/or the prescription of medications, unless specifically authorized in 234 CMR 5.07 and 5.12. For a listing of specific procedures a registered dental hygienist may perform and under what supervision go to www.mass.gov/dph/boards/dn

[Paula Evans]

For those on Medicare, what do you suggest for dental coverage in Massachusetts?

Ms. Evans...Unfortunately, Medicare only supports limited dental services determined to be medically necessary, such as a dental exam prior to kidney transplantation or heart valve replacement, extractions performed in preparation for radiation treatment involving the jaw or jaw reconstruction following accidental injury. Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures.

Massachusetts does have three dental schools and several dental hygiene schools, as well as about 50 community health center dental programs that provide low-cost and/or no-cost dental care dependant upon income status. We also have a few not-for-profit programs in Massachusetts that will match a resident over the age of 65 in need of dental care with a dentist in their community willing to provide services at a lower cost.

If you are interested in knowing what resources may be available in or near your community, please contact my office directly.

[Delores]

Hi Lynn,

I just got my dental hygiene license by credentials in MA. I currently live and practice hygiene in CA. I am going to be visiting family for the month of July. I have family in Boxford and Newburyport. Can you direct me to any temp agencies near these locations? I am interested in working some of the time I am in MA. Any suggestions would be great.

Thank you,
Delores

Hi Delores

I would recommend you contact the Massachusetts Dental Hygienists' Association (MDHA) for information on temporary employment opportunities in the state. MDHA's contact information may be found on their website at www.massdha.org. July is a great month to spend in the Commonwealth...hope you can find some time to be a tourist while you are here!

[Emma]

With the changes in Mass Health for Adults, I was told by the administer of a community health center that there would be long waits and long lines. There are many seriously ill adults loosing their restorative services at dentists they trust. I find the decision to put ill and elderly patients through this change apalling and insensitive. Many people will give up caring for their teeth.