Archive for Behind the Headlines
April 22, 2009 at 8:17 pm by Ian Kerr
Filed under Behind the Headlines
A double page spread in Tuesday (April14th 2009) Daily Mail Good Health section highlights some of the sorry tales from NHS dentistry. All the tales are very sad and reflect the problems of funding under the new contract. The article is the usual mix of exaggeration and dramatic wording (teeth are never extracted in the Daily Mail they are always “ripped out”) but this does not undermine the truth of the situation. I highlighted this problem in April 2007 with the introduction of new costs for root canal fillings and the rise in extractions that this would bring and it is no surprise to see this now happening.
If you run a health care business you can not ignore the financial side for long before your business goes bust. Dentists undertake all of the funding, loans, mortgages etc to set their practices up without any assistance from anyone. If they do not make a profit they will loose their business and sometimes their homes as well. Under these situations it is inevitable that a system that leaves vast sections of dental care loss making to the dentist, is going to lead to under treatment- surely no one can be surprised by this or say that it was not inevitable.
The lead part of the article relates to a young lady of 21 who has lost all her teeth through gum disease. This is a truly extreme case and one that in 20 years of treating gum disease in general practice, hospital clinics and specialist clinics I have never seen but it does highlight the need for early diagnosis of gum disease. The key risk factors for gum disease and early signs are listed below. I would recommend anyone who has concerns over the gums to seek a dental consultation to have their gums assessed. At StoneRock this costs £89, which buys an hour of our time along with all the necessary intra-oral radiographs, photographs and full discussion of your dental health followed by a full written report. Even in times like these this strikes me as excellent value for money and probably the best £89 any one will ever spend on their teeth.
Risk Factors for gum disease-
- Smoking
- Diabetes
- Family history of gum disease
Early Signs
- Gums bleeding on brushing
- Tender swollen gums
- Most gum disease is symptomless in the early stages so even if you do not have these signs, please get them checked.
- By the time teeth become loose or painful it is often too late.
If you would like to find out more about your gums the please do not hesitate to contact the surgery on 01580 752202 and we will be happy to arrange a consultation visit for you.
January 5, 2009 at 9:19 pm by Ian Kerr
Filed under Behind the Headlines
The Daily Mail, has broken with tradition and allowed a sensible piece of health reporting slip through the net. The article in Friday 2nd January “Jaw disease alert for women taking osteoporosis pills” does actually address an important issue.
Medications known as bisphosphonates have long been known to have a link with a potentially very serious condition called osteonecrosis of the jaw (ONJ), although the risk is considered to be highest for patients taking the medication intra-venously and for patients undergoing treatment for cancer (especially chemotherapy). This article highlights the smaller but still significant risk for patients taking Fosamax and presumably other bisphosphonate oral medications.The article quoted in the paper can be seen in the Journal of American dental Association (JADA) and states that the overall number of cases is low (between 600-700 cases reported by the end of2006) with most related to IV administration. That said there is growing concern about oral administration and the advice seems to be clear that patients about to begin treatment in any form should seek a thorough dental examination first, with a view to completing elective treatment before the drug is administered. This is particularly relevant to patients with gum disease and possible dental infections as extractions appear to be a trigger for ONJ in bisphosphonate takers. StoneRock Dental Care is leading the way in preventive protocols for at risk patients using new “minimum Intervention” principles based around remineralisation of weakened enamel and dentine and home care techniques to ensure that everything possible is done to prevent the need for treatment in at risk patients.
If you are taking such medication or are about to and would like to discuss the implications with one of our dentists then please do not hesitate to contact the dental surgery on 01580 752202 and we will be happy to arrange an appointment.
September 22, 2008 at 9:07 pm by Ian Kerr
Filed under Behind the Headlines
Congratulations to Rebecca Smith of The Daily Telegraph for this weeks grossly inflated claims. Her article “Toothbrush and the drill could soon be history”sticks to the strict code of making something out of nothing that all science writers seem to do now. Her use of the word “could” is oustanding using it 4 times in the first few paragraphs to show us what our future might be like.
Sadly the word “could” can be inserted in to almost any sentence to make what ever claim you feel like with impunity. She is of course correct the dentists drill could soon be redundant but there is absolutely no reason to believe this to be the case from her article. The piece relates to remineralisation techniques and a photo activated disinfection system both of which are of use in minimally invasive procedures when treating minor cavities. It is lovely to think that these will change our approaches in years to come and I am very hopeful that a probiotic approach using xylitol and calcium phospate gels will help prevent early cavities but none of these systems will remove the need for conventional management of the tens of millions of already filled teeth. Clearly a dental drill will be needed for several decades to manage these teeth.
The good news is that the conventional management of these teeth can be done in a pain free, comfortable procedure that, when combined with existing disinfection techniques and traditional oral hygiene instruction can provide very predictable results. All new developments that help with this are warmly welcomed but talk of replacement of drills and tooth brushes is wildly off the mark. Although I could be wrong I suppose.
September 4, 2008 at 7:53 pm by Ian Kerr
Filed under Behind the Headlines
This week’s report comes courtesy of the Daily Mail. An article written on Wednesday September 3rd “Deflated charges at the blow-up dental surgery” reports on the introduction of a mobile dental unit, from Hungary, designed to give patients consultations and an insight into how much their dental charges would be if they traveled abroad to have the work.
Before we talk about the inflatable tent we should give special mention to the level of reporting, which, on balance, is exactly as I would expect it to be. The author, Jaya Narain, refers to an x-ray gun and shield never before used in the UK which is, in fact, relatively common place now. (It was first demonstrated to me 3 years ago, when lecturing at Kings, and is used by my good friends at Senova Dental Care). She also refers to a price for general anaesthetic which has not been used in general dental practice in my working life time ( I qualified in 1989 and don’t like to dwell on how long this makes my working life time). I assume she is referring to conscious sedation and this is an important distinction. General anaesthetic (GA) is a hospital based procedure and any costs incurred for in hospital treatment are going to be significantly higher than those in general practice. As ever, the failure to report simple facts correctly does raise question marks over any other claims made in the article.
On the subject of fees I was interested to read the overall costs quoted. As a principle partner of an entirely private multi-discipline specialist center I am always interested in the competition’s prices and I note with interest that the fees quoted for UK are between 25 and 50% higher than our fees for four out of 8 on the list. Either this means I am slowly becoming Hungarian or the reporter has done the usual trick of sampling the very highest UK prices and comparing them (presumably) with the very lowest Hungarian ones. The reference to Harley Street was an interesting one. This address is used in media terms to denote either the very highest of prices and standards or, if the mood dictates, the ultimate in sleaze and deception. The truth is, of course, that it represents neither. It’s reputation within the profession is, at best, mixed. Some good dentists work their and some not so good. The address is proof of nothing other than high rent to pay.
As for the tent and the mobile service. It is a novel idea and clearly represents a good money making business model for those involved in health tourism. I have no knowledge of the standard of service available and the efficacy or ability of the dentists involved (just as I have no knowledge of the other UK dentists working in the area). According to the Radio 1 News at 5.45pm their reporter who tried it found it a bit noisy and reported that it had blown over in high winds but I have no confirmation of this. The concept of a second opinion is a valid one and may be of great value to some patients. Shopping on price alone is a dangerous game in any field of medicine and dentistry as their are many other factors that will determine what is best for you. I have covered this in a previous entry (Putting the Miles into Smiles) so won’t repeat them here but will say, as ever, choosing the right dentist for you is based on a two way conversation used to develop a trust and understanding so that you can agree on what is the very best and most appropriate care available.
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