Dentist Alpharetta: Dr. Nanci Lubell Joins The Right Smile Center

Sandy Springs’ Right Smile Center, a full service dental practice is excited to announce the addition of Nanci Lubell, DMD as a new associate in the practice.

Dr. Lubell brings the Right Smile Center 20 years of experience with a focus in restorative and endodontic treatment.

We are fortunate to have someone of Dr. Lubell’s experience and training in our practice,” said Dr. Novy Scheinfeld.  “She brings a successful track record of great service with the added technical expertise that allows us to offer our patients in-house endodontic treatment.

Dr. Lubell grew up in East Cobb and returned to practice there after receiving her degree from MCG in 1991.  Married to native Atlantan Dr. Mark Rosing, Nanci currently resides in Dunwoody with their two sons who attend The Davis Academy. In addition to her dental degree, Dr. Lubell has Bachelor of Science in Microbiology from the University of Georgia.  Throughout her career she has been active in various cancer-related charities and women/children shelters in metro Atlanta.

The Right Smile Center is one of the largest active comprehensive dental practices in North Atlanta and has been trusted by thousands in metro Atlanta with 4 generations of patients.  If we can be of assistance in your oral health care needs please do not hesitate to call our office for a complementary consultation.

The Right Smile Center

Scheinfeld, Tourial and Lubell

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

www.rightsmilecenter.com

info@rightsmilecenter.com

404-256-3620

Dentist Roswell: Dr. Nanci Lubell Joins The Right Smile Center

Sandy Springs’ Right Smile Center, a full service dental practice is excited to announce the addition of Nanci Lubell, DMD as a new associate in the practice.

Dr. Lubell brings the Right Smile Center 20 years of experience with a focus in restorative and endodontic treatment.

We are fortunate to have someone of Dr. Lubell’s experience and training in our practice,” said Dr. Novy Scheinfeld.  “She brings a successful track record of great service with the added technical expertise that allows us to offer our patients in-house endodontic treatment.

Dr. Lubell grew up in East Cobb and returned to practice there after receiving her degree from MCG in 1991.  Married to native Atlantan Dr. Mark Rosing, Nanci currently resides in Dunwoody with their two sons who attend The Davis Academy. In addition to her dental degree, Dr. Lubell has Bachelor of Science in Microbiology from the University of Georgia.  Throughout her career she has been active in various cancer-related charities and women/children shelters in metro Atlanta.

The Right Smile Center is one of the largest active comprehensive dental practices in North Atlanta and has been trusted by thousands in metro Atlanta with 4 generations of patients.  If we can be of assistance in your oral health care needs please do not hesitate to call our office for a complementary consultation.

The Right Smile Center

Scheinfeld, Tourial and Lubell

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

www.rightsmilecenter.com

info@rightsmilecenter.com

404-256-3620

Dentist Dunwoody: How Much do Veneers Cost?

So how much do veneers really cost? The cost for porcelain veneers varies widely. They can run anywhere from $925 to $2,500 per tooth. There are several reasons for the difference in cost and it also varies widely across the United States.  And yes, one might consider veneers to be quite expensive but they do offer several benefits.  One of which is a distinctly improved smile.

First, lets discuss what porcelain veneers are.  Porcelain veneers are extremely thin custom made covers for the front surface of the teeth. They can be made from porcelain or direct composite resin.  Although porcelain veneers are more expensive than composite, they last much longer and are more stain resistant.  Traditional composite veneers last on average between five and seven years while porcelain veneers last between 10 and 18 years.

Veneers are used for a variety of purposes. They can be used to fix chipped or broken teeth or teeth that have become discolored by root canal work, excessive fluoride, or drugs such as tetracycline. Porcelain veneers can also be used to correct misaligned teeth or teeth with gaps between them.  But the most common reason for veneers is cosmetic. They can be used to change the length, shape, size and color of teeth. In effect, they can be used to create a designer smile.

There is also a difference in cost between having the procedure done in a metropolitan area versus a small town. Another cost variation is the difference in cost from one ceramics lab to the next. The number of veneers done also affects cost. A single veneer usually is more expensive per tooth than a set of veneers.

Because veneers are considered a cosmetic procedure, they generally are not covered by insurance. In some cases, depending on the insurance company and the policy coverage they may be eligible for a dental discount. Again, the amount and availability of this discount varies widely.  In special circumstances some insurance may pay up to 50% depending on the type of policy. To offset the high cost of veneers, most dentists offer special payment plans.

Getting dental veneers is a multi-step process. The initial visit usually consists of a consultation and depending on the dentist and the amount of work to be done, x-rays and/or impressions of the teeth may be done at this time.  On the first working visit the dentist will remove approximately 1/2 millimeter of enamel from the tooth or teeth to be veneered and make a model to send to the lab that will make the veneer.  This is most often done with a local anesthetic. Normally it takes one to two weeks to construct the veneers.  During the next visit, the veneer is temporarily placed to check for proper color and fit.

The tooth that is to receive the veneer is then cleaned, polished, and etched. The etching roughens the surface of the tooth for better adhesion of the veneer. The veneer is cemented into place and a follow up visit to check placement and adhesion may be required.

How long do porcelain veneers last?  They can last between five and ten years or more, depending on how you take care of them. But at some point they probably will need to be replaced. Just like real teeth, porcelain veneers need to be thoroughly brushed and flossed daily.

Your smile is the first things that people notice about you which is the primary reason people want porcelain veneers.  If we can be of service or you have any questions, please feel free to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

Related articles

• Dentist: Dunwoody, GA : So what exactly are dental veneers? (therightsmile.wordpress.com)
• Dentist Acworth: How Much do Dental Crowns Cost? (therightsmile.wordpress.com)
• Dentist Acworth: How Much Do Dentures Cost? (therightsmile.wordpress.com)
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Dentist Roswell: How Much Do Teeth Cleanings Cost?

So you got a mailer coupon from a dentist that says they only charge $49.95 for a regular cleaning & $19.95 for an exam & x-ray.  Seems kind of a cheap gimmick?  And a lot of the times it might be, it just depends on the practice.  If it’s a mature practice you might want to question why they are giving away services.  Usually, it’s a loss leader, something they use to get you in and pressure you into other dental procedures.

If it’s a new practice, then providing discounted services is one of the few methods a new practice has to introduce itself to the surrounding community, no different than a new restaurant trying to showcase its menu.  The genuine intent is to build a relationship by showcasing the practice.

Dental costs will vary widely, depending on where you go and the quality of the practice you see.  With respect to continuing care (on your next 6 month visit), a teeth cleaning charge is going to range somewhere around $65 to $89, but it can be more if there’s a need to do a full mouth root scaling. Often dental insurance will cover some or all of this cost for a specific number of cleanings per year.  The exam is $45 to $55 and the 4 basic bite wing x-rays are around $59 to $72.  Depending on your insurance this might be covered anywhere from 60 to 100% after a small deductible is met.   Periodic X-rays ($32 -$135) are needed to see if any problems are developing inside the teeth or around the jaw bone, and are generally required before cleaning the teeth of a new patient (which is why some practices offer coupons to defray the initial cost of a first visit). These are also often covered by dental insurance.

The main goal of professional teeth cleaning is to prevent gum disease, which is the primary cause of tooth loss.  Dental hygiene is imperative, and cleaning your teeth is the first step toward their long term preservation.  In a standard cleaning, a dental hygienist (working under a dentist’s supervision) removes soft plaque and hard tartar (mineralized plaque that builds up on the teeth and can only be removed with professional instruments) from above and below the gum line on all the teeth. The process requires one office visit and usually takes about 30 to 60 minutes.

The more extensive deep cleaning process called scaling and root planing is done by quadrants (upper right, upper left, lower right, lower left) at a cost of about $100 -$400 per quadrant depending on the severity of the problem or $400 -$1,600 for the entire mouth, but more often than not, if the mouth is in such poor health the dentist will refer the patient out to a periodontist.   Most dental insurance includes these procedures.

Again, the goal is a healthy mouth which an integral part of your overall health.  Oh, and by the way, just because you had your teeth cleaned professionally, the jobs not done.  You have to do your part and brush and floss daily if you want to keep them.   If you have additional questions, feel free to email or call our office.  Our goal here is to create an informed patient.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

 

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Dentist Sandy Springs: How Much do Veneers Cost?

So how much do veneers really cost? The cost for porcelain veneers varies widely. They can run anywhere from $925 to $2,500 per tooth. There are several reasons for the difference in cost and it also varies widely across the United States.  And yes, veneers can be quite expensive but they do offer several benefits.  One of the benefits is a distinctly improved smile.

First, lets discuss what porcelain veneers are.  Porcelain veneers are extremely thin custom made covers for the front surface of the teeth. They can be made from porcelain or direct composite resin.  Although porcelain veneers are more expensive than composite, they last much longer and are more stain resistant.  Traditional composite veneers last on average between five and seven years while porcelain veneers last between 10 and 18 years.

Veneers are used for a variety of purposes. They can be used to fix chipped or broken teeth or teeth that have become discolored by root canal work, excessive fluoride, or drugs such as tetracycline. Porcelain veneers can also be used to correct misaligned teeth or teeth with gaps between them.  But the most common reason for veneers is cosmetic. They can be used to change the length, shape, size and color of teeth. In effect, they can be used to create a designer smile.

There is also a difference in cost between having the procedure done in a metropolitan area versus a small town. Another cost variation is the difference in cost from one ceramics lab to the next. The number of veneers done also affects cost. A single veneer usually is more expensive per tooth than a set of veneers.

Because veneers are considered a cosmetic procedure, they generally are not covered by insurance. In some cases, depending on the insurance company and the policy coverage they may be eligible for a dental discount. Again, the amount and availability of this discount varies widely.  In special circumstances some insurance may pay up to 50% depending on the type of policy. To offset the high cost of veneers, most dentists offer special payment plans.

Getting dental veneers is a multi-step process. The initial visit usually consists of a consultation and depending on the dentist and the amount of work to be done, x-rays and/or impressions of the teeth may be done at this time.  On the first working visit the dentist will remove approximately 1/2 millimeter of enamel from the tooth or teeth to be veneered and make a model to send to the lab that will make the veneer.  This is most often done with a local anesthetic. Normally it takes one to two weeks to construct the veneers.  During the next visit, the veneer is temporarily placed to check for proper color and fit.

The tooth that is to receive the veneer is then cleaned, polished, and etched. The etching roughens the surface of the tooth for better adhesion of the veneer. The veneer is cemented into place and a follow up visit to check placement and adhesion may be required.

How long do porcelain veneers last?  They can last between five and ten years or more, depending on how you take care of them. But at some point they probably will need to be replaced. Just like real teeth, porcelain veneers need to be thoroughly brushed and flossed daily.

Your smile is the first things that people notice about you which is the primary reason people want porcelain veneers.  If we can be of service or you have any questions, please feel free to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

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Dentist Sandy Springs: How Much Do Teeth Cleanings Cost?

So you got a mailer coupon from a dentist that says they only charge $49.95 for a regular cleaning & $19.95 for an exam & x-ray.  Seems kind of a cheap gimmick?  And a lot of the times it might be, it just depends on the practice.  If it’s a mature practice you might want to question why they are giving away services.  Usually, it’s a loss leader, something they use to get you in and pressure you into other dental procedures.

If it’s a new practice, then providing discounted services is one of the few methods a new practice has to introduce itself to the surrounding community, no different than a new restaurant trying to showcase its menu.  The genuine intent is to build a relationship by showcasing the practice.

Dental costs will vary widely, depending on where you go and the quality of the practice you see.  With respect to continuing care (on your next 6 month visit), a teeth cleaning charge is going to range somewhere around $65 to $89, but it can be more if there’s a need to do a full mouth root scaling. Often dental insurance will cover some or all of this cost for a specific number of cleanings per year.  The exam is $45 to $55 and the 4 basic bite wing x-rays are around $59 to $72.  Depending on your insurance this might be covered anywhere from 60 to 100% after a small deductible is met.   Periodic X-rays ($32 -$135) are needed to see if any problems are developing inside the teeth or around the jaw bone, and are generally required before cleaning the teeth of a new patient (which is why some practices offer coupons to defray the initial cost of a first visit). These are also often covered by dental insurance.

The main goal of professional teeth cleaning is to prevent gum disease, which is the primary cause of tooth loss.  Dental hygiene is imperative, and cleaning your teeth is the first step toward their long term preservation.  In a standard cleaning, a dental hygienist (working under a dentist’s supervision) removes soft plaque and hard tartar (mineralized plaque that builds up on the teeth and can only be removed with professional instruments) from above and below the gum line on all the teeth. The process requires one office visit and usually takes about 30 to 60 minutes.

The more extensive deep cleaning process called scaling and root planing is done by quadrants (upper right, upper left, lower right, lower left) at a cost of about $100 -$400 per quadrant depending on the severity of the problem or $400 -$1,600 for the entire mouth, but more often than not, if the mouth is in such poor health the dentist will refer the patient out to a periodontist.   Most dental insurance includes these procedures.

Again, the goal is a healthy mouth which an integral part of your overall health.  Oh, and by the way, just because you had your teeth cleaned professionally, the jobs not done.  You have to do your part and brush and floss daily if you want to keep them.   If you have additional questions, feel free to email or call our office.  Our goal here is to create an informed patient.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

info@rightsmilecenter.com

 

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Roswell Dentist: How much do dental fillings cost? and Why?

The cost of a filling can vary greatly, depending on who you go to, the type of filling and degree of restoration required.   An amalgam (“silver/mercury filling”) is cheaper than a composite (white/resin filling), but will last significantly longer if you are unconcerned about aesthetics and the back and forth debate over whether or not amalgams may be linked to other health issues.  The US Food and Drug Administration (FDA) and the American Dental Association (ADA) found there is no danger from an amalgam filling, but some specialists and consumers remain unconvinced by the findings.

One of the ways to find out the actual range of cost is to just call a local dentist from the internet and ask them.  You are going to find some hesitancy to quote over the phone because each person presents a different set of restorative circumstances, but you should be able to get a range of costs or a free consultation.

While costs vary from one area to the next and from one office to the next, the cost of typical amalgam filling ranges from approximately $75 to $175 per filling, whereas a composite resin filling ranges from $125 to $300 for a single surface restoration.  You should expect about 3 to five years (possibly 7 years) of use from the composite and as many as 20 years or longer from an amalgam restoration.  Actually a well-cared-for amalgam filling can last a lifetime, so the expensiveness of the filling really becomes a minor consideration.

Restorative circumstances are going to vary from tooth to tooth and decay may be found in one small spot or throughout a tooth. The restorative fees are based on the number of surfaces needing filling in a single tooth.  A silver amalgam filling on one or two surfaces averages $75 to $175, while for three or more surfaces it could go as high as $120 to $300 or more.  The same type of logic follows with respect to composite restorations.  Since composite resin fillings are more time consuming and require greater skills to completion they are more expensive than amalgam fillings and weigh in on the more expensive side of caries restorations.

Typically dental insurance covers most or all of the costs of a silver amalgam filling, but only 50 to 80 percent of the cost of a composite filling because the higher charge for the tooth-colored material is considered a cosmetic option. One exception is when an old amalgam filling is cracked or broken and is replaced with a composite filling.

Your dentist should be advising you of the type of filling based on the size of the cavity and the location of the tooth in your mouth.  Amalgams are more likely to be placed in the back of your mouth while composites are more likely to be used on more-visible front teeth. WebMD.com gives an overview of typical filling procedures and Colgate.com lists pros and cons of different types of fillings.

Amalgam Advantages

• Amalgam fillings are strong and can withstand the forces of chewing.
• They are relatively inexpensive and last a long time, compared with alternatives.
• An amalgam filling is completed in one dental visit.

Amalgam Disadvantages

• Amalgam doesn’t match the color of your teeth.
• Healthy parts of your tooth often must be removed to make a space large enough to hold an amalgam filling.
• Amalgam fillings can corrode or tarnish over time, causing discoloration where the filling meets the tooth.
• A traditional amalgam filling does not bond (stick) to your tooth, so the cavity preparation developed by your dentist requires undercuts or ledges to provide retention of the filling.  Your dentist may have to remove additional tooth structure to establish good retention for the filling.  
• Some people may be allergic to mercury or be concerned about its effects, although research shows the amount of mercury exposure from fillings is similar to what people get from other sources in the environment.

Composite Advantages

• Your fillings will match the color of your teeth and therefore undetectable.
• A filling should be completed in one dental visit.
• Composite fillings can bond directly to the tooth, making the tooth stronger than it would be with an amalgam filling.
• Less drilling is involved than with amalgam fillings because your dentist does not have to shape the space as much to hold the filling securely.  The bonding process holds the composite resin in the tooth.
• Indirect composite fillings are heat and light cured increasing their strength.
• Composite resin can be used in combination with other materials, such as glass ionomer, to provide the benefits of both materials.

Composite Disadvantages

• Although composite resins have become stronger and more resistant to wear, they generally don’t last as long as amalgam fillings under the pressure of chewing.
• The composite may shrink when placed; this can lead to more cavities in the future in areas where the filling is not making good contact with your tooth.
• This restoration takes more time and skill to place because they are usually placed in layers. The increased time and labor involved also contribute to the higher cost (compared with amalgam fillings).
• Indirect fillings and inlays take at least two visits to complete. Your dentist takes impressions at the first visit and places the filling or inlay at the second visit.
• In large restorations, composites may not last as long as amalgam fillings.

The trick is to find a qualified, well trained dentist, and that requires you to educate yourself about the dentist you choose and a basic knowledge about dentistry.  If we can be of service or answer any questions or concerns please feel free to contact us.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

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Roswell, GA: ADA Accredited Prosthodontist is Your Cosmetic Dentist

Prosthodontists are dental specialists certified in tooth restorations such as implants, bridges, crowns, dentures and veneers to give you the best smile possible, more important they provide the right smile. They are ADA accredited specialists in esthetic and cosmetic dentistry.  After graduating from dental school with a D.D.S. or equivalent degree, prosthodontists receive three additional years of rigorous specialty training in a university or hospital ADA accredited graduate education program.

If you are seeking cosmetic, implant or reconstructive dental work, you should see a prosthodontist, because prosthodontics is the only specialty recognized by the ADA that is involved with esthetic and cosmetic dental restorations and implant restorations.   None of the other specialties are taught both the form and the function of restorative dentistry.  Patients should understand that terms like ‘Cosmetic Dentist’, ‘Implantologist’ or ‘Implant Specialist’, are not designated specialties recognized by the American Dental Association.  While these terms may be very descriptive, they are also terms that attempt to get around ADA designated specialties.

Prosthodontists are experts in the dynamics and esthetics of a smile, the preservation of a healthy mouth and the science of tooth replacement.  With the passage of time prosthodontic dentists are gaining popular recognition with respect to their qualifications to offer state-of-the-art procedures and techniques as patients become more familiar with the advances in modern dentistry.  Of the 170 thousand dentists in the country less than two (2%) percent are trained prosthodontists.  So, when your dentist refers you to a prosthodontist you should know you are in well trained hands.

Many of those referring specialists think of the prosthodontist as the “conductor” of a dental treatment plan, the professional in the process with the big picture in mind.  They usually lead a team of specialists to develop ideal solutions to your dental needs because they are responsible for the final restoration.   They provide the highest level of dental care being expertly trained in many different clinical disciplines with the anticipation that a working knowledge of various disciplines is necessary to produce optimal results for the patient.

The combination of all these various disciplines rest comfortably within the purview of a prosthodontist’s training and expertise.  A comprehensive approach by a prosthodontist as the conductor is the best way to get your inner confidence boosted, your personality improved and the right smile.  If you have any questions or concerns please feel free to contact us.

Dr. Scheinfeld received her prosthodontics degree from Emory University School of Dentistry in 1988.

Novy Scheinfeld, DDS, PC                                                                                                            

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

receptionist@rightsmilecenter.com

www.rightsmilecenter.com

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Dentist: Roswell, GA : A Prosthodontist is your ADA cosmetic dentist.

It seems to be prevalent these days that most dentists are touting themselves cosmetic dentists.   But in reality, there is no such specialty designated as cosmetic dentistry.  If there was a cosmetic specialty it would probably come under the ADA sanctioned prosthodontic degree.  With the passage of time prosthodontic dentists are gaining popular recognition as patients become more familiar with the advances in modern dentistry.  Of the 170 thousand dentists in the country only about two (2%) percent are trained prosthodontists.  They are expert dentists with a post graduate ADA recognized degree centered around a complete knowledge of dentistry, where function as well as beautification of teeth are combined in the final result.

There are a lot of people in this world who just weren’t born with beautiful smiles or for other circumstances ended up with damaged teeth.  Some inherited stains from medicines their parents took prior to child birth, while others developed discolorations through the years that make their appearance unattractive whenever they open to either talk or smile. These people can be helped by  prosthodontic dentists who specialize in the cosmetic restorations that provide methods, procedures and plans which ultimately improve their personality as much as  improves their mouth.

The first advantage of a prosthodontist is time related.  As a result of their extensive post graduate training and experience with difficult cases, modern techniques take much less time in the beautification of the teeth as compared to older ordinary dentistry.  Techniques and procedures as common as in-house whitening which takes only couple of hours as opposed to otherwise days of the repeated home bleaching have become fairly common place and routine in the restoration of a smile.

Another major change related to teeth is implants.  In the past there had been an extensive time period involved in replacing missing teeth.  Now, while still a complex procedure there are alternatives that with significant preparation allow for teeth to be implanted in a day and utilized by the patient shortly thereafter.  The prosthodontist is generally considered the quarterback of most implant procedures.

Finally, technology often comes into play with veneers which are made up of a special material and again while technique sensitive are very easy to incorporate into quick, favorable and long lasting natural results.  The combination of all of these techniques rest comfortably within the purview of a prosthodontist’s training and expertise.  A comprehensive approach by a prosthodontist is the best way to get your inner confidence boosted and your personality improved.  If you have any questions or concerns please feel free to contact us.

Dr. Scheinfeld received her prosthodontics degree from Emory University School of Dentistry in 1988.

 

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

receptionist@rightsmilecenter.com

www.rightsmilecenter.com

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Dentist: Roswell, GA : Oral Health Care of Our Aging Population

Two important oral health care concerns emerging in the United Statesare disparities in the oral disease burden and the inabilityof certain segments of the population to access oral healthcare.[1]  Older Americansare becoming a larger segment of our population and suffer disproportionately from oral diseases, with the problembeing particularly acute for individuals in long term care facilities.  Populationprojections for the United States indicate that the elderlywill constitute an increasing percentage of the population aswe proceed into the 21st century.  In 2001, the population ofthe United States was almost 278 million, and 12.6% of the populationwas 65 years of age or older. By 2015, the population is expectedto increase to 312 million (3.08 million in 2010) and 14.7% of the population willbe aged 65 years or older.  In 2030, which is within the practicelives of students currently enrolled in dental schools, thepopulation will have increased to more than 350 million, and20% of the population—1 of every 5 members of the US society—willbe 65 years of age or older.  This large segment of our population is further compounded by the elderly populationcontinuing to become increasingly diverse in terms of race, ethnicity,financial resources, and living conditions.[2]

The challenges faced by both the dental profession and the nationas a whole regarding provision of oral health care servicesto older adults were the subject of a recent report preparedby Oral Health America.[3]  All 50 states were surveyed to determine the level of Medicaidcoverage for dental services, and the report concludes thatfinancing oral health care services for the elderly will be a majorchallenge to our future.  Medicare does not provide any coverage for dentalservices, and only 1 of 5 Americans aged 75 years or older hasany type of private dental insurance.  Given our current economic circumstances it will be highly unlikely that our government resources will be adequate to gear up for the impending problem of oral health for the elderly.

The elderly suffer from chronic disorders that can directlyor indirectly affect oral health, including autoimmune disorderssuch as pemphigus and pemphigoid.[4] They generally requiremultiple medications, and common side effects of the more than500 medications used to treat their overall health issues usually reduce salivary flow.[5]   Usually the reduction in salivacan adversely affect their quality of life, the ability to chew, and lead to significant problems of the teeth andtheir supporting structures.

The elderly may also have difficulty performing routine oralhygiene procedures because of physical limitations, such as Parkinson’s or rheumatoid arthritis.   In addition,oral infection is now recognized as a risk factor for a numberof systemic diseases, including cardiovascular diseases, cerebrovascular diseases,diabetes, mellitus, and respiratory disorders.  Also,it is important to note that once people have lost their teeth and are using complete dentures, their oral healthneeds do not decrease.   Our jaws are not static and may continue toresorb over time.  Besides the continued resorption of bone, improperly fitted dentures can adversely affectchewing, leading to poor nutrition.  In addition, those without teeth remainsusceptible to oral cancer, mucosal diseases, and alterationsin salivary gland function.

So for the vast majority of seniors who will reside in a long term care facility, financingof oral health care services will be a formidable challenge.Given that medicare does not provide coverage for routine dental services including exams,and in the absence of private insurance or personal resources,a large portion of this group will not be able to afford anydental services whatsoever, let alone the most appropriate treatments.  Clearly, there must be a response to the increasing oral healthconcerns of the elderly who present with special needs, especiallythose who are homebound or living in long term  facilities burdenedwith other chronic disorders.

While effective preventive measures exist for younger populations(water fluoridation, dental sealants and parents), no preventive measureshave been devised to address the expected increase in oral healthneeds of the aging population.  And the need for a coordinated effort to address the oral healthcare needs of the elderly suggested by demographic trendsand epidemiological data necessitates our planning for what might be considered a crisis or at least a paradigm shift in oral health care delivery for the elderly.  Such a plan must consider contributionsfrom the dental profession, possibly through the efforts ofthe American Dental Association (ADA) and its state and localassociations; the dental schools, with involvement of the AmericanDental Education Association; federal, state, and local healthauthorities; and assistance from national organizations andfoundations that focus on health care.  The dental profession has an opportunity to take a leadershiprole in the delivery of health care services to the seniorswho have contributed so vitally to our society’s well-beingand who deserve to be treated with the best oral health carewe have to offer.

Dr. Scheinfeld is a prosthodontist specializing in geriatric care.

Novy Scheinfeld, DDS, PC

290 Carpenter Drive, 200A

Atlanta (Sandy Springs), GA 30328

404-256-3620

www.rightsmilecenter.com

receptionist@rightsmilecenter.com

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[1]Oral Health in America: A Report of the Surgeon General. Rockville, Md: National Institute of Dental and Craniofacial Research; 2000.

[2] Wikipedia and 2010 Census.                                                                                

 

[3] A State of Decay: The Oral Health of Older Americans. Chicago, Ill: Oral Health America; 2003:1–8.

[4] Stoopler ET, Sollecito TP, De Ross SS. Desquamative gingivitis: early presenting system of mucocutaneous disease. Quintessence Int.2003;34:582–586.

[5] Fox PC, Eversole LR. Diseases of the salivary glands. In: Silverman S, Eversole LR, Truelove EL, eds. Essentials of Oral Medicine. Ontario, Canada: BC Decker; 2002:260–276.