Ohio Health Policy Review

ADA concerned about lead in dental crowns and prostheses

"The American Dental Association (ADA) has begun a "larger-scale investigation into the safety of both foreign and domestically produced dental crowns and other dental prostheses." (Source: "Lead might be lurking in dental work," Columbus Dispatch, Feb. 28, 2008.) The ADA became concerned after WBNS Channel 10 in Columbus worked with a local dentist to order "eight supposedly identical dental crowns from four labs in China, the source of a growing number of dental implants used by U.S. dentists. The labs are regular advertisers in industry publications distributed in the United States. A certified testing facility in Cleveland found that the porcelain veneer of one of the crowns contained lead -- 210 parts per million."

As a result of the investigation, the ADA warned its members about the lead found in the crown and contacted federal authorities, including the Food and Drug Administration and the Centers for Disease Control and Prevention. The ADA also began its own investigation. Dr. Marcel Casavant, chief of pharmacology and toxicology at Nationwide Children's Hospital and medical director of the Central Ohio Poison Center, said the lead-tainted crown signals a potential health threat. "I guess that tells me I need to be a little bit more concerned about other potential sources of lead," Casavant said, "and I never would have guessed somebody would have put lead into a piece or a part installed into a human being.

Ohio kids on Medicaid have trouble finding dentists

The Toledo Blade published an article on Sunday detailing the shortage of dentists in northwest Ohio who will accept children who are on Medicaid. (Source: "A gap that needs to be filled: Dentists for Medicaid kids" Toledo Blade, Jan. 20, 2008.) "Low reimbursement rates are chief among the reasons why dentists don't routinely accept disabled or poor children covered by Medicaid. Programs in Ohio, for example, pay about 51 cents on the dollar." According to Dr. Paul Casamassimo, a past president of the American Academy of Pediatric Dentistry, "A lot of dentists can't afford to take Medicaid. It costs them money to take care of the kids." This lack of care results in dentists who do treat Medicaid recipients seeing "emergency cases where children have infections from abscessed teeth because they don't get routine dental care. In rare cases, such infections--as with a 12-year-old Maryland boy last year who had no dental insurance at all--are fatal."

Despite this, statistics show that the move to Medicaid managed-care programs in recent years in Ohio has helped increase the percentage of children seeing dentists. "Ohio, for example, has had a 20% hike in the number of Medicaid-covered children getting help over the last five years, with about half of those aged 4 to 21 having a dental visit in the fiscal year ending June 30, 2006, according to the Ohio Department of Job and Family Services."

Zanesville-Muskingum Health Dept. receives grant to expand dental clinic

"The Zanesville-Muskingum County Health Department is developing plans to expand its dental clinic services with the help of state and federal funding due to demand." (Source: "Health Dept. Dental Clinic expanding," Zanesville Times Recorder, Jan. 11, 2008.) A new grant from the Ohio Department of Health will help pay "half of the salary for a full-time dentist position and future revenue growth could permit hiring a part-time dentist and three more support staff positions."

Raising awareness about link between diabetes and dental problems

The Summa Health System Center for Dental Health in Akron is trying to raise awareness about the link between diabetes and dental problems. (Source: "Blood sugar is a danger to teeth," Beacon Journal, Dec 11, 2007.) "Though eye screenings and foot exams routinely are recommended for patients with diabetes, routine dental care too often gets overlooked," said Dr. James Salem, an endocrinologist and chief of Summa's endocrine division. Diabetic patients are at increased risk for gum disease, as well as periodontitis, which spreads to the supporting structures of the tooth. In addition, many diabetics have severely dry mouths because of salivary gland dysfunction and without an adequate amount of saliva, teeth are prone to dental decay. Among Salem's recommendations are that dentists "give diabetic patients antibiotics before dental procedures and intense fluoride treatments at home and in the office."