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Dentist blog from Delta Dental

Author: Delta Dental (Page 1 of 25)

Dentist spotlight: Dr. Erin Bang-Crooks

Dr. Erin Bang-Crooks, DDS, knew she wanted to work in the dental industry since she was just a teenager. Passionate about creating meaningful relationships, Dr. Bang-Crooks says that it was the promise of getting to know her patients while maintaining a solid work/life balance that sold her on the idea of being a dentist.

After graduating from Columbia University and a residency in New York City, she sought out a balance between the hustle of New York City and her hometown of Birmingham, Alabama. She landed in Alpharetta, Georgia and opened a small boutique practice called Ivy Dentistry — a nod to her Ivy League education.

Now with two decades of experience in dentistry, Dr. Bang-Crooks says it’s still those same values of creating and maintaining relationships that keep her going — and that’s why she’s our May Dental Health Partner of the Month!

When did you decide that you wanted to be a dentist and why?

I’ve always liked the idea of the health care field and being able to help patients, but it actually started during high school when a rep from dental school came by and gave us a talk about the shortage of women dentists back then. They talked about the flexibility of hours and balancing your life and career.

What do you love about being a dentist?

I love my patients and the interactions and relationships. I like the fact that I’m helpful in educating them about dentistry and understanding the importance of it. I’m happy being a general dentist because I get to see them more often than I would as a specialist.

Generally, dentistry allows you to have a relationship with patients over a long period of time. There are not many jobs where you have that kind of privilege. I get to see my patients every six months over many years. It’s the best watching young patients grow up right before your eyes. That’s how you really know you’re getting older!

If you could go back in time, what advice would you give to yourself when you were first starting out?

It’s helpful if you know early on what you want to do, but if you don’t, just keep exploring different things until you figure that out. Once you’re committed, just go for it and give it 100%. You’ll just sort of become your authentic self. You can figure out who you are through that.

Most importantly, balance your life. I think if you do too much of anything you can lose sight of other priorities, responsibilities or interests, and it sort of takes over. The challenge in life is to have a nice balance with family, career, friends, relationships. In the end, that’s what it’s about: relationships.

How do you do stay balanced?

It’s a constant struggle. Being a working mom, wife, sister, friend. We wear many hats. Dental health is important, but your overall health is really important. If you don’t have your health, everything is harder to manage. I like staying fit and having a healthy attitude towards life.

We all expire. If you think about that, it puts a lot of things in perspective. When we have hard times, we have to remember that we’re all here and we all have an expiration date, so try to make the best of it. If you think about things that way, that problem that you have might not feel so gigantic. Make the best of it every day.

Do you have any funny stories from the dental office?

It’s HIPAA protected, so what happens in Dr. Bang’s office stays here. My lips are sealed. I have plenty of funny stories, but I can’t tell you.

What are the biggest challenges in the industry?

I think the nuanced language in insurance can be confusing to patients. It can be very tricky. I’d like to see it simplified as much as possible so that anyone could understand it.

In honor of Asian American and Pacific Islander Heritage Month, we’d love to know more about the AAPI figures that you admire. Who are the people who have motivated you in your life and career? How do you use what they taught you?

For me, it’s just family, especially my father who passed away many years ago. He’s always been an inspiration to me. My brothers and I try to emulate his values. I guess that’s how you know what’s important. Even if someone passes away, they still can have influence over you. 

He was a very simple man. He was the strong silent type and didn’t say much. It was always shown through actions. He valued family and friends and wasn’t pretentious. He was a very moral person, and it was a good foundation for our family.

He walked a lot, too. He walked every day, and now I find myself doing that. It’s weird how it just subtly becomes part of you. I find myself doing a lot of the things he used to do. He was a great dad.

What do you do in your free time? Any hobbies?

I’m into fitness and I like being healthy. I actually have a very inspirational personal trainer named James, who I’ve worked with for about two years and want to give a shout out to. In the beginning, I really hated the strength training part, but I’m beginning to embrace it more.

Personal training comes with a lot of life lessons. It’s not that I enjoy the process, but once you do it you feel stronger and you feel proud because you made it through. You kind of just endure. You can apply that towards life, in a lot of ways. It can be intimidating, but the more you practice and do it, the more you see the value in it.

In some ways, I hope that patients feel that way about dentistry. They can be very intimidated about coming in — they don’t want to be here. But once they get to that point where they see the value, the light switch goes off. These days, everything is quick and easy, but I’m trying to preserve those relationships with my patients. I try to treat them like family and help them relax and slow down a bit.

Now that COVID restrictions are beginning to change across the country, what are you looking forward to this year?

It’s been a difficult time, but at the same time I think it helps you self-reflect. I think this true for a lot of people. It makes you prioritize things a little better. It’s really about relationships. That’s what was lacking during COVID. We physically couldn’t be near anybody. When you’re deprived of something, you realize how much you appreciate it.

I really appreciate the simple things in life. I walk more. I take my time sipping my coffee a little longer. I’m looking forward to having a deeper relationship with the people around me and diving in to make them more meaningful. It starts with working with the people who are already around you.

On-site quality assessment review checklist for 2021

The California Department of Managed Health Care mandates on-site quality assessment (QA) reviews for dentists in California. These reviews are helpful in comparing your own practice to the expectations of regulatory agencies and other dental professionals.

Getting acquainted with the aspects of a QA review is a great opportunity to improve your practice’s policies and procedures, while also preparing for future on-site assessments.

QA reviews focus on two aspects: structure and records. Follow the checklist below to get started on your own assessment and make note of what may need correction.

1. Structural review (about 20 minutes)

The structural review involves an assessment of the facility and equipment, as well as sterilization protocols.

Facility and equipment

  • Facility is clean and well maintained.
  • Dentist name and office hours are posted.
  • Procedure manual includes protocols for appointments, complaints, broken appointments and specialty referrals.
  • Accommodations exist for patients with disabilities, such as wheelchair access and a grab bar in the restroom.
  • Waterlines have anti-retraction valves installed and maintained with properly flushed handpieces and waterlines.

Radiology

  • Certificates are current and equipment inspection dates are posted.
  • Lead (or lead-equivalent) apron with thyroid collar is used.

Sterilization and infection control

  • Staff is trained in infection control standards and procedural logs are kept.
  • Gloves, masks, protective attire and eyewear are used appropriately.
  • Weekly biologic monitoring is conducted and records are kept.
  • Instruments and handpieces are properly sterilized, stored and labeled.

Safety and emergency procedures/equipment

  • Drugs, syringes and needles are properly stored and a log is kept of drugs dispensed on site.
  • Required certifications are up to date.
  • A modern evacuation system exists for nitrous oxide.
  • Written office protocol includes staff responsibilities for evacuating patients in emergencies or natural disasters. The evacuation plan with clearly marked exits is displayed.
  • An active contact system can reach the dentist 24/7.
  • A portable emergency oxygen is available, full and there is a positive pressure valve and/or Ambu bag; staff are trained in use.
  • Mercury hygiene and safety requirements are observed.
  • Medical emergency kit is up to date.

2. Records review (about 1 hour and 45 minutes)

This portion involves a review of your patient care documentation.

Medical and dental history

  • Medical history forms include yes/no questions, identify patient’s existing conditions and contain comprehensive health information.
  • Dental history includes baseline information, TMJ/occlusion status, appliances, periodontal condition and results of soft tissue/oral cancer exam.

Treatment notes

  • Progress/treatment notes are legible and in ink.
  • Included, as appropriate, are: 
    • Referrals to specialists
    • Records forwarded or received
    • Anesthetic used (type, amount and concentration of any vasoconstrictor)
    • Medications prescribed
    • Laboratory instructions

Quality of care

  • Professionally acceptable standards of care are observed for: 
    • X-rays — adequate number, appropriate frequency, of diagnostic value, mounted and labeled
    • Treatment plan — in ink, consistent with diagnosis and exam findings, alternative and elective treatment documented with the patient’s choice and reason
    • Treatment sequence — in order of need
    • Informed consent — documentation that treatment plan was reviewed and patient understands risks, benefits, alternatives and costs; any refusal of recommended care is documented

Outcomes of care

  • Patient records demonstrate effectiveness of preventive care
  • Overall comprehensive documentation demonstrates that treatment was provided as appropriate, including: 
    • Good prognosis for appropriate longevity
    • Evidence of need (x-rays, pocket charting etc.)
    • Minimal unplanned treatment or retreatment
    • Referral to a specialist in a timely manner
    • Post-operative instruction given
    • Follow-up (pocket charting, x-rays etc.)

New CDT codes for COVID-19 vaccination

In March 2021, the Code Maintenance Committee of the American Dental Association (ADA) added seven new codes designed to report the delivery of COVID-19 vaccine. These codes have been added to the preventive category of service.

Additionally, a new code for molecular testing has been added to the diagnostic category of service.

These services are covered under medical plans and therefore will not be covered by Delta Dental. If you administer COVID-19 vaccines in your dental office, check with your patients’ medical carriers for more information about coverage.

New CDT codes as of March 29, 2021:

  • D0606 — molecular testing for a public health related pathogen, including coronavirus. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility
  • D1701 — Pfizer-BioNTech Covid-19 vaccine administration – first dose. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility.
  • D1702 — Pfizer-BioNTech Covid-19 vaccine administration – second dose. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility.
  • D1703 — Moderna Covid-19 vaccine administration – first dose. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility.
  • D1704 — Moderna Covid-19 vaccine administration – second dose. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility
  • D1705 — AstraZeneca Covid-19 vaccine administration – first dose. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility
  • D1706 — AstraZeneca Covid-19 vaccine administration – second dose. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility.
  • D1707 — Janssen Covid-19 vaccine administration. This procedure is not a benefit of most Delta Dental plans. The fee is the patient’s responsibility.

Positioned for success: workplace ergonomics in the dental office

Imagine you’re in the middle of a clinical procedure. Are your neck and upper back straining as you try to get a better view? Are your hands and wrists clenched and tense? Are your legs dangling or crossed? If you answered “yes,” you’re not alone.

Many people struggle to maintain good posture throughout the day. Unfortunately, bad posture can contribute to the development of musculoskeletal disorders (MSDs) like carpal tunnel syndrome, arthritis and muscle strain. For dentists and other dental professionals, MSDs are the leading cause for early retirement. At least 62% of dentists report one musculoskeletal complaint, with the most prevalent areas of pain being in the lower back and neck.

The good news is that you don’t need to accept pain as a part of your job. With proper ergonomics, you can identify and address work-related pain.

What is ergonomics?

Ergonomics is a philosophy that promotes designing workplaces to fit human needs so workers don’t need to strain to perform their jobs. The goal is to make you more efficient without compromising your safety. You can do this by maintaining a neutral position as much as possible and limiting tasks that cause strain. That means setting up workstations so everything you need is in reach or using special equipment, like footrests, to maintain a 90-degree bend in the knee.

Equipment can’t do all the work, though. State-of-the-art tools and gadgets should be paired with good posture to prevent potential MSDs. Practicing good posture is also the cheapest and quickest way to begin an ergonomic program.

What does good posture look like?

Unfortunately, careers in oral health are rife with opportunities to slouch and strain. To prevent MSDs, take note of these tips for good posture.

  • Spinal alignment. Maintain an erect, neutral spine instead of bending forward or leaning over the patient.
  • Proximity. Move your stool as close as possible to the patient’s head to minimize the need to overextend your arms or back.
  • Position. Keep your feet flat on the floor or the footrest of your stool. Adjust your stool height so your thighs slope slightly downward. Sit, rather than stand, for all clinical procedures. Hold your wrists in a neutral position and minimize wrist movement.
  • Weight distribution. Evenly distribute your weight in a tripod pattern, through each foot on the floor and your stool.
  • Equipment. Consider using a loupe to minimize the need to perch on the edge of your stool to see. If your overhead light is too dim or casts too many shadows, consider a head-mounted light as an alternative. Avoid gripping instruments tightly.
  • Stretching. When possible, take 10 minutes to get up and stretch your spine, arms and legs. Stretching during and after work can help relax strained muscles.
  • Exercise. Some poor posture habits begin with a weak core. Your core muscles act as a brace to your lower back when engaged, but using them all day can be exhausting. Train your core to make it easier to maintain good posture.

With tight schedules and productivity quotas, it can be difficult to prioritize time-consuming tasks like re-positioning patients. If you can’t eliminate strain, reducing it is still helpful. One easy way to reduce strain is to have your patients scoot to the end of the headrest once the chair is reclined. Eliminating those few inches between the top of their head and the top of the headrest shrinks the space for you to lean over.

The ergonomic office

For practice owners, investing in ergonomic training and supporting healthy practices has long-term benefits like preventing unwanted retirement, reducing canceled appointments and lessening the need for disability leave.

Ultimately, though, these suggestions are just the beginning. Most dental tools were developed with an average male dentist in mind, which may put people with smaller builds at a disadvantage. With ergonomics, there isn’t one solution to address every problem. You need to consider your and your team’s individual needs.

When implementing changes, remember to include the whole office. Your practice manager and front desk assistants also have ergonomic needs like monitor positioning and desk height. Encourage your team to communicate when they’re struggling with strain so that issues can be addressed early on. Approve time off to visit the doctor when needed. 

Even small changes can have a huge impact towards becoming an ergonomically healthy practice.

Why your patients’ blood pressure matters

In addition to your exam findings, do you evaluate your patient’s blood pressure readings? May is National High Blood Pressure Education Month, when you can renew focus on the importance of heart health in oral health and total wellness care.

The time you take for a blood pressure reading gives you vital information for your patient’s gum treatment, which may reduce hypertension risk.

The causal link between gum disease and hypertension

A March 2021 research study showed that patients with periodontitis and no other health issues are twice as likely to have elevated blood pressure as those with healthy gums. This may suggest that periodontal bacteria can trigger an inflammatory response that affects blood vessel function and lead to the development of hypertension.

When does blood pressure signal health risks?

A normal blood pressure reading is less than 120 mm Hg systolic and less than 80 mm Hg diastolic, according to Centers for Disease Control and Prevention (CDC) guidelines. You should be concerned if the systolic/diastolic reading falls into one of these categories:

  • Elevated: 120-129 mm Hg and less than 80 mm Hg
  • Stage 1 Hypertension: 130-139 mm Hg or 80-89 mm Hg
  • Stage 2 Hypertension: >140 mm Hg or > 90 mm Hg

Hypertension puts your patients at risk for heart disease and stroke, the leading causes of death in the U.S. Nearly half (45%) the adults in the U.S. have hypertension or are taking medication to control it, according to the CDC, and only 24% of them have it under control.

The dangers of gum disease

Gum disease triggers inflammation that thickens the lining of blood vessels. The thickening plaques decrease blood flow, which increases the risk of heart disease and stroke.

Patients with healthier gums had lower blood pressure and responded better to medications, compared to those with periodontitis, according to an analysis, published in Hypertension, based on review of medical and dental exam records of more than 3,600 people with high blood pressure. 

What’s more, periodontal therapy can make a difference. Intensive periodontal treatment lowered blood pressure levels (12.67 mm Hg/9.65 mm Hg) in patients over six months, after a four-week intervention, according to a clinical study published in 2017 in the Journal of Periodontology.

How you can educate your patients about high blood pressure

With this in mind, use your blood pressure check as an opportunity to educate your patients. If you notice an elevated reading, discuss the importance of getting blood pressure under control.

And you can explain how keeping gums healthy can contribute to better circulation and heart function through lowering blood pressure.

Your periodontal treatment and advice on daily flossing and brushing regimens take on added value for your patient, in reducing risks from hypertension.

Adjust claims online in Provider Tools

Need to make an adjustment to a claim? You can now submit a claim adjustment online in Provider Tools.

How to submit claims online

It’s easy: Just log in to your Provider Tools account. New to Provider Tools? Register for an account.

Once you’re logged in, click on My Claims, locate the processed claim you want to adjust and click on the claim ID. One the next page, scroll down to Claim Adjustment, click Submit a request and select the reason for the adjustment.

Next, make the adjustments, including any attachments or additional explanations. If there are multiple lines that need adjustment, add the details in the explanation box.

Click Continue to review your changes. You must agree to the terms before you can submit your request.

After submission, you’ll receive a confirmation and tracking number. Claims adjustments can take up to 30 days to process. No further action is needed from you.

Which claims are eligible?

Claim adjustment is eligible for all claims submitted to us within the last 90 days. It doesn’t matter whether your original claim was submitted through Provider Tools, a third-party claim clearinghouse or by mail.

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