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.
With more and more people receiving COVID-19 vaccines, you may be adjusting scheduling availability for your office to handle in-person visits. Be prepared for a busier spring and summer for your practice, as patients return for care and open enrollment season begins.
Take a moment to ensure your office information is correct in the Delta Dental directory. Please check your listing and provide any updates, such as office hours, languages spoken by staff, and more.
You can easily revise listing information in Provider Tools. Or you can update it via a form and return it by email or by fax.
For current and potential patients, the directory is a trusted resource. They can use the Find a Dentist search tool to easily locate your office and plan visits.
Quality dental care is essential for people to stay healthy as they return to normal lifestyles. Make it easy for them to connect to your office, whether it is through the online Delta Dental directory or popular websites.
Here are links to update your information on heavily searched sites:
Happy National Deaf History Month! If you haven’t heard of this awareness month, it runs from March 13 to April 15. Nearly 15% of adult Americans report trouble hearing, so you may have patients who have hearing issues and aren’t even aware of it. If you don’t know American Sign Language (ASL) yourself, you may be at a loss for where to begin. Fortunately, there are plenty of steps, from the simple to the more complex, that you and your staff can take to help your deaf and hard-of-hearing patients feel at ease.
Have office protocols for serving deaf and hard-of-hearing patients. With a little bit of planning and forethought, you and your staff will be ready to welcome your deaf and hard-of-hearing patients from the moment they make an appointment until the moment they schedule their next one and head home. Make sure that your patients can schedule appointments without having to make a phone call, such as by text message, email or social media. You should also think about little touches for when your patient arrives, such as offering a dental cup to patients who may want to remove their hearing aids while they’re in the chair. (Hearing aids can be shockingly expensive and are definitely not something your patients want to lose!)
Speak slowly, clearly and directly facing your patient. This helps your patient read lips, as well as avoiding the possibility of carrying on a conversation with a patient’s “bad” ear. Given that you and your staff will likely be wearing a mask because of COVID-19, speaking slowly and clearly even more essential (you can also use clear facemasks).
Go the extra mile to make your patients feel comfortable. Patients who are experiencing hearing loss from old age may be embarrassed that they can’t follow conversations as closely as they used to. If you notice that a patient isn’t quite hearing you, apologize and repeat yourself with a focus on slow, clear communication.
Encourage your patients to talk openly with yourself and their other doctors. As a dental professional, you may notice a patient’s sensitivity to sound (or lack thereof) or other issues before the patient does. If you suspect that some of your patients may have hearing issues they’re not aware of, encourage them to consult their physician or a specialist.
These are all great steps that any practice can follow to better serve patients who are deaf and hard of hearing. If you have patients with greater needs, or you simply want to develop your practice’s capabilities, there’s even more you can do.
Taking it to the next level
Add more electronic text throughout your practice. The prevalence of text-based tools like email, online messaging and chat apps has been a game changer for many people who are deaf and hard of hearing. Increasing your digital presence and making your practice available through multiple venues both helps new patients to find you and existing patients to contact you through their preferred method. If your practice regularly posts videos on YouTube or other services, make sure that the videos are captioned.
Take American Sign Language (ASL) classes or add someone to your staff who knows ASL. Having staff members who know languages other than English is both a great way to reach a wider part of your community and a nice perk when it comes to updating your Find a Dentist directory listing. If you already have staff who are fluent in ASL, make sure you mention that on your directory listing! If your staff doesn’t have anyone who knows ASL, you can find classes at local universities, colleges and community colleges, as well as more specialized institutions like schools for deaf people, deaf service centers or interpreter training programs. If you’re not ready or able to sign up for classes, you can always learn a few key phrases online.
Make use of Delta Dental’s Language Assistance Program (LAP). The LAP is a free service that your Delta Dental patients can use to get professional interpretive services (along with phone assistance, written materials and more). This includes ASL interpreters who can come to your office to assist in communication.
More than 35 million people in the United States report having trouble hearing, whether they suffer from mild hearing loss or are completely deaf, so thinking about how to serve this population is well worth your time. Whether you want to master ASL or you just want to begin accepting appointments by email in addition to the phone, taking steps to make your practice more inviting to patients who are deaf and hard of hearing is well worth your time.
When he was receiving a dental cleaning many years ago, Dr. Daniel Croley had a conversation that changed the course of his life and career. At the time, he was a college student with a pre-med major headed toward medical school, but a serious talk with his dentist opened his eyes to a new path.
After shadowing the dentist for a few weeks to learn about his practice, Dr. Croley realized that the profession would be a great fit.
“Throughout my life, I’ve been interested in helping people, and making a meaningful impact,” he said. “I liked the patient interaction, and dentistry’s focus on prevention spoke to me.”
While earning a B.S. degree in zoology and a DMD degree at the University of Kentucky, he gained practical experience working in hospitals, where he “fell in love with patient care” while assisting patients with disabilities or medical conditions requiring stronger oversight.
Today, Dr. Croley serves as Delta Dental’s chief dental officer. In his new role, he builds on his years in private practice to inform his work overseeing Delta Dental’s dentist networks.
From private practice to dental insurance
After earning his DMD, Dr. Croley moved to Chicago and managed two dental practices for eight years. Although he loved the work, he suffered a severe shoulder injury, related to repetitive strain, that caused him to seek care from several specialists.
The risk to his health was too great, and it was an emotional decision to leave practice. He began looking for a new position that would allow him to use his knowledge and skill “in a meaningful way to help people get healthy.”
Dr. Croley worked for seven years for a third-party administration company, which eventually became Humana. He then received a call from PMI, an HMO subsidiary of Delta Dental of California, and he accepted a position to manage its dental networks.
“I found my way to the dental benefit world and it was a fit for sure,” he said. “When I was in practice, I helped one person at a time, and now I could influence many more people through my work overseeing quality delivery of care across many providers.”
Shaping Delta Dental’s care and vision
After a brief period working for the American Dental Association, Dr. Croley began his role as vice president of network development at Delta Dental.
“Having worked for other insurance companies, I knew Delta Dental to be the best in class,” he said, “and this is continually confirmed. This is a great, caring compassionate company.”
As vice president of network development, he emphasized the goal Delta Dental shares with dentists: bringing health to our communities. He described a partnership of trust that supports dentists as business owners, healers and community members.
Improving the quality of dental care
Now, as chief dental officer, Dr. Croley has another goal: improving the quality oral health care that patients receive.
“When you think about what patients want,” he said, “it’s access, affordability and quality.”
While he was serving as director of informatics at the ADA, Dr. Croley made two significant observations: (1) the value of data and using data to inform decision-making, and (2) the shared focus of dentists and dental plans — the patient.
Combining these ideas fits into Dr. Croley’s plans as chief dental officer. Defining quality is the first step in the process, he said, and then identifying objective measurements against expected outcomes.
”We will be building transparency around the quality of care that dentists deliver to patients,” he emphasized.
To do this, Delta Dental will be helping to facilitate dentists’ understanding of what quality is and empower them to achieve it in their interactions with, and services to, patients.
Today’s practice challenges for dentists
The COVID-19 pandemic has taken a toll on dental practices. As dentists face ever-changing conditions in 2021, Dr. Croley sees planning as a key to the return to pre-COVID-19 patient volumes and practice revenue.
“COVID has been hard on dentists, and it’s been harder in some states, like California and New York,” he pointed out. “Patient traffic is down in dental offices, both because some people are afraid of catching the virus and so many have lost their jobs.”
However, patient volumes nationally have increased to an estimated 78% of their pre-COVID-19 level, according to an ADA poll taken Dec. 14, 2020. Dentists have applied infection control, sanitization and sterilization measures in their practices all along, Dr. Croley observed. The key, he said, is to “just make sure their patients feel safe to come back into care. People cannot put off their preventive and restorative dental care.”
While the pandemic has increased costs for personal protective equipment (PPE) and caused difficulty with staging and scheduling, Dr. Croley advises dental offices to adjust their business practices to the new conditions, such as changing their hours of operation.
“Dentistry is both a business and a clinical profession,” he said. “We want to help practices remain stable in the market.”
A shared purpose
Through participation in Delta Dental’s networks, which are the largest in the nation, dentists can attract patients, and patients covered under Delta Dental plans can access quality care.
Ultimately, Dr. Croley said, “Delta Dental and dentists share a fundamental purpose: improving health through affordable, quality care.”
As the COVID-19 vaccine is becoming more accessible throughout the country, you may find more of your patients talking about it and asking questions. Unfortunately, there’s a lot of conflicting and inaccurate information being spread through various media channels. Staying on top of the truth can be a full-time job, but here’s a list of common questions and some points you can bring up in case your patients come to you with concerns about the vaccine.
Concerns about catching COVID-19 from a vaccine shot. There is no live virus used in the vaccines, so people who receive them can’t contract COVID-19.
Concerns about the vaccine damaging cells’ DNA. mRNA vaccines don’t alter cell DNA. Instead, they teach cells how to make a protein, which generates an immune response that will help cells target similar proteins in the COVID-19 coronavirus.
Concerns about the vaccines being developed recklessly or too quickly. The vaccines have been tested on tens of thousands of patients. Pfizer and Moderna have published ingredient lists for their vaccines, and the mRNA technology used to make the vaccines has been in development for over 30 years.
I’ve heard reports of people having aches, chills and other symptoms after getting vaccinated. Is this an issue?
No. Some people who have gotten the vaccine have reported muscle pain, chills and headaches, but that is not unusual for vaccines. These are part of the body’s normal immune response. But if you’ve had an allergic reaction to vaccines in the past (which is due to the ingredients used in the vaccines), then you should first consult with your health care provider.
Should I still get a vaccine if I’ve had COVID-19 previously?
Yes. It’s not clear if having contracted COVID-19 previously grants long-term resistance and immunity, like chicken pox does. Even for those who have been infected previously, the CDC still recommends getting vaccinated.
COVID-19 doesn’t seem that deadly. Should I get a vaccine if I’m not in a high-risk category?
Yes. It’s true that as a percentage, most people who contract COVID-19 don’t die from it. Still, there can be serious long-term consequences such as lung, heart or brain damage. And even someone who doesn’t get seriously ill can still spread the disease among others who are more vulnerable. Getting a vaccine helps you protect not just your family and loved ones, but also society as a whole. These are important reasons to get the vaccine.
Once I’ve been vaccinated, do I still need to wear a mask or socially distance?
Yes. Even if a person has been vaccinated, that doesn’t mean that he or she can’t still spread the virus. It takes at least 10 days for the body to develop antibodies, and the number of antibodies present only goes up with more time. Additionally, research hasn’t conclusively determined if the vaccines prevent asymptomatic infection and spread (although it is likely that they do). Wearing a mask and socially distancing are also good behaviors to model for those who haven’t been vaccinated yet. By getting vaccinated and following other preventive measures, you can do your part to end the pandemic sooner!
I’ve heard that the vaccine contains a chip inside that lets the government and corporations track people who get vaccinated. Is this true?
No. Some syringe makers include a microchip within the label of their syringes so that health care providers can track the shipping history and origin of doses of vaccine, but there is no chip in the vaccine itself.
I heard that the vaccine targets a protein that occurs naturally in pregnant women and can cause fertility issues. Is this true?
No. An amino acid sequence is shared between COVID-19 and a placental protein found in pregnant women, but the sequence is too short to trigger an immune response by itself. COVID-19 vaccines won’t cause fertility issues in women.
For further information on key facts about the vaccine and how you can play a role as a trusted health care provider, please consult the American Dental Association’s COVID-19 vaccine page.
It’s easy to believe that cyberattacks won’t happen to you. Why would a criminal choose your office as a target over corporations with more money and assets? Big businesses have plenty of resources to throw at security and firewalls, whereas your office may only have a few basic protocols in place. Better yet, every patient record they get can be sold online for over $400! About 79% of all reported data breaches in the first 10 months of 2020 were against health care entities, according to a report by Fortified Health Security. Understanding what risks exist in your office and proactively addressing them will help keep you and your patients safe, especially with moves towards teledentistry during the COVID-19 pandemic.
How data breaches happen
Internet-enabled devices within your office offer many points of entry for a criminal. Any computers, security cameras and tools connected to the internet can be open doors to thieves who want in.
Hacking and IT incidents are the biggest cause of data breaches, accounting for 69% of reported incidents. IT incidents include malware that’s installed by clicking on links in phishing emails or visiting unsecure sites.
The second leading cause was unauthorized access, which resulted in 20% of all breaches. This includes mistakes, like a lost tablet or folder of patient information, or intentional sharing of information by an insider in your office.
Teledentistry and additional risk
Teledentistry, while a fantastic option for reaching patients, opens a new door for cyberattacks. Text messaging and free video chat software aren’t viable options for telehealth, because all communication between you and your patients must be encrypted to be compliant with HIPAA.
The Office for Civil Rights (OCR) at the Department of Health and Human Services has announced that it will not penalize health care providers for using popular video chat applications during the COVID-19 pandemic, with a few caveats. You should notify your patients that these apps can introduce privacy risks and you should enable all available encryption and privacy modes when using them.
While some tools without encryption, like Skype and Facebook Messenger, have been given the go-ahead by OCR for use during the pandemic, HIPAA-compliant tools offer better protection of patient data.
Although you can never be completely invulnerable to attacks, having strong practices can make the difference between a scare and a nightmare.
The first steps you can take to proactively manage risk are some of the easiest:
Wi-Fi. Only use password secured Wi-Fi networks. If your office wants to have a network for patients or staff’s personal devices, create a password protected guest network.
Passwords. Use strong passwords on all your office devices. A strong password contains at least 10 characters and includes numbers, symbols, uppercase and lowercase letters. And remember to keep them safe. Don’t create strong passwords only to write them down on a sticky note!
Software. Before buying new applications, rigorously vet their compliance with HIPAA. A company might say its product is for health care practices, but that doesn’t mean it complies with laws around protected health information (PHI). And when you buy software, make sure to install updates promptly, since many software updates fix security problems that could be exploited by hackers.
Physical documents. If your office plans to dispose of hard copies of documents with patient information, destroy them so that any PHI is indecipherable and cannot be reconstructed.
Team protocols. Set up and enforce security protocols with your team. Have a regular, holistic evaluation of your protocols and how well they’re being followed. The National Coordinator for Health Information Technology (ONC) has a great list of tools, training and guidance to help you maintain your office’s strong security practices.
Beyond that, you can greatly reduce the financial burden of a breach by getting cyber insurance that covers the cost of investigating thefts, compensates for fines and penalties and funds lawsuits and legal fees.
If a breach does happen, take action immediately. Determine how the breach occurred and what information was affected. Get in contact with legal counsel before anyone else.
It’s going to take work and will probably be frustrating if you’re just starting out. But by implementing a strong cybersecurity defense, you’ll know you’ve done everything you can to keep your practice and patients safe.