The health-seeking 70-year-old

Posted on February 20, 2012

You have read on this blog how age is positively associated with health-seeking behaviour. The older one gets, the less one smokes and the more the daily activity increases.

Another recent survey conducted in the UK amongst 1,002 adults age 55 and over, confirms this behaviour.1 The survey conducted for Simplyhealth, the cash-plans provider in dental care, found that:

  • 8 out of 10 70+ year olds, try to keep fit and healthy.
  • More over 70s claim they focus on fitness than those in their 50s and 60s.
  • The key issue for fitness was affordability but 1 in 4 said that companies (dental practices?) target the young and ignore the old in their services.

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Dental health literacy: the importance of clear and actionable information called the Partners in Prevention

Posted on February 16, 2012

There is increasing recognition that to improve health outcomes, health literacy must increase. Patients need to know the cause and effect of their condition and what to do to get better and stay better. Most importantly, the level of health literacy is associated with the likelihood of receiving preventive care.1

Health literacy is the “patient’s capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions.”2 The only survey of American health literacy found 12% of adults were proficient, a third were “basic” or “below basic” literacy levels and about half were at an intermediate level, meaning that they may or may not follow post-treatment instructions.

It is widely recognized that the medical system often gives short shrift to educating patients – it is time consuming and the current healthcare model is largely built on the cycle of crisis care and a poor understanding by the patient on improving and protecting health.

Is it any different in dental care? Dental literacy has consisted primarily of instruction on how to brush and floss, and how often to visit the dental office. Importantly, the UK Adult Dental Health Survey of 2009 reported that the vast majority of adults regularly brush and floss yet it also reported one in three adults continue to get tooth decay.

So a new approach to adult dental health literacy seems needed for those at high risk.
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Smoking Cessation and Tooth Decay: What’s the Connection?

Posted on February 13, 2012

A recent issue of The New York Times reports one study found that the nicotine patch and nicotine gum are ineffective long-term strategies to stop the smoking habit.

There are several observations on this study from a dental perspective:

  1. More than 1 in 5 adults in the UK smoke and those that do have more tooth decay (Chart 1). This connection may be due to exposed roots due to periodontal disease (which is closely associated with smoking), poorer oral hygiene amongst those who smoke, and a general lack of health-seeking behaviour.

    2. Continue reading →

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Getting Patients to Take Charge of Their Health

Posted on February 9, 2012

In her blog titled “Getting Patients to Take Charge of Their Health”, Dr. Pauline Chen, M.D. talks about how to engage adult patients to take better care of their chronic diseases. Her message applies to dental care as the population ages and has a growing burden of dental disease.

Dr. Chen says that it is easy and customary to blame the patient for being sick. But she also points to some novel research on patient engagement conducted at a network of 40 family medical clinics in Minneapolis called Fairview Health Services.

For almost two years, Fairview Health Services has been giving patients a survey to measure how actively involved they are in their health care. The survey includes just 13 questions and takes only a few minutes to complete, with patients responding to statements like, “I know what my prescribed medications do,” “I am confident I can tell my health care provider concerns I have even when he or she does not ask,” “and “I am confident that I can maintain lifestyle changes like diet and exercise even during times of stress.”

Having answered these questions, patients are then placed into one of four categories depending on how likely they are to understand their health care issues and how much confidence and skill they have to take care of themselves.

The survey results of over 25,000 Fairview Health patients were analysed and compared those results with various objective measures of wellness like blood pressure, body mass index, blood sugar and cholesterol levels, emergency department use and hospitalizations.

Although not all the differences were dramatic, patients who were more involved in their health were less likely to smoke, be obese, get hospitalized or go to the emergency room than those who were less engaged. And while more affluent patients tended to be healthier than those who were poorer, patients who were more active in their own care tended to be in better health than their peers, regardless of income.

In dental care, the customary approach to patient involvement involves oral hygiene instruction and reminders about better eating habits. However, studies show that such efforts have a temporary effect at best particularly amongst high risk adults who have well developed lifestyles and habits.

Getting high risk patients more engaged in better oral health needs to go beyond these conventional approaches. A good place to start is with a simple but instructive assessment of the patient’s risk for caries.

Ross Perry

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Dentistry – An Essential Service or an Elective Service?

Posted on February 6, 2012

Regular visits to the family dental practice have become a good barometer of the economy. They rise when times are good and fall when times are bad.

A recent study [PDF] by NPR and the Kaiser Family Foundation found that amongst all healthcare services, dentistry was most affected by the growth of long-term unemployed in the United States (Chart1). More than 6 in 10 such adults skipped dental care or checkups. Surveys of UK dental office attendance have found a similar phenomenon – since the start of the recession, regular visits have declined to levels seen 10 years ago.

Pundits report there will be a continuation of long-term unemployment, underemployment and part-time employment. Perhaps 1 in 5 workers will have this status. This will continue to challenge the recovery of regular recall visits.
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Oral Healthcare of Older patients in the UK

Posted on February 2, 2012

The British Dental Association has warned in a recently published report that the quality and availability of oral healthcare for older adults remains an issue and that insufficient priority is being given to making improvements. The report says that the health and well-being of older adults is poorly served and there are concerns for the future. Oral health is often not properly considered in the wider healthcare provision and may patients just don’t get the care they need. The chair of the BDA’s UK Healthcare policy, Dr Robert Kinloch, said “Good oral health is as important for older adults as it is for younger patients. Being able to eat, communicate and socialise confidently all depend on maintaining a healthy mouth”.

In a BDA report of 2003 21 recommendations were made for improving oral care for older people, sadly only six of those recommendations have been met in full. This recent report sets out 12 priorities for reform, including free comprehensive oral health assessments for the over 60s.

This failure to provide good oral healthcare for the older patient reflects badly on our society and the provision of dental care in the United Kingdom. Many dentists cannot understand why this is happening although it may be that those that I have spoken with recently are particularly interested in prevention as the new dentistry and know that there is an alternative to the constant need for restoration and prosthetic treatment for the older patient.

With Prevora as a new preventive coating for adults at high risk of tooth decay there is now another weapon in the fight for better oral health for the older patient.

Penny Hardaker

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The Importance of Practice Promotion

Posted on January 30, 2012

As we near the end of the first month of 2012 the dental press and business magazines are full of the need for the promotion of dental practices and businesses. One particular article in the dental press stated that “there are not many practices in the UK that would say ‘No’ to attracting more patients”. Increasing patient numbers leads to an increase in turnover and profit and once there are sufficient patients to cover overheads any additional patients means income which goes straight to the bottom line.

How can a practice attract new patients?

Word of mouth? Yes, this is effective and also satisfying when you know that a new patient has come because of a recommendation.

Local press and advertising? It is a known fact that advertising works and in straightened times not many businesses can afford to neglect this even though when money is tight is may be tempting to do so. However this has to be planned, monitored and sustained. One advert is rarely enough and to be thoroughly effective advertising needs to be linked to press coverage and sustained PR. Once this is achieved “word of mouth” also becomes more effective. Patients and prospective patients TALK.

This all takes valuable time and energy and with all the other things that have to be attended to in the modern dental practice there are often not enough hours in the working day. For those dentists who are using Prevora there is now an alternative. Dentists in the South of England who have joined the growing Partners in Prevention network of practices providing more preventive care in response to the needs of older patients can be part of PR and advertising campaign in the national media to promote this service. For more information see www.partnersinprevention.co.uk or call 01483 246303.

Penny Hardaker

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Positive Thinking!

Posted on January 26, 2012

The current doom and gloom in the media at present is enough to make even the most cheerful person sink into the depths of despair! Continuing problems with the Euro, a shipping disaster, a major supermarket issuing a profits warning and unemployment up again – the list goes on and on! Christmas is now well and truly over and the New Year no longer seems new, so, in the long dark evenings what is there to cheer everyone up?

One of the major UK dental magazines has just landed on my desk and in the current climate I hardly dared open it, but courage was rewarded. Amongst the problems and continuing talk of recession there were several contributions which were positive and, in the words of Roger Matthews from Denplan, “It’s a great time to be in dentistry!” Roger admitted that there were problems but spoke about how challenging times bring out the best in business. He went on to say that by undertaking a practice review now and making the best choices for patients not only would profitability increase but when the economic recovery comes profits would romp away.

Adding to this was a contribution from the Immediate Past President of the BDTA who said that the successful dentist would be looking at ways to keep the appointment book full. The BDTA has been running a campaign to convince the over 45s that they need to take care of their teeth and research from other organisations is expected to produce a public facing campaign to see how the dental industry can promote the industry to the public. This is in line with the long running proDente in Germany which aims to ensure that the Germans are aware that investment in oral health has positive benefits to overall health.

Although there were other positive contributions these two really caught my attention and enthusiasm because this is what Prevora is all about! Encouraging dentists to offer new initiatives to their patients, which act as practice builders, give patients what they want and encourage patients to look at good oral health as part of good overall health. To support this mantra Prevora will be running a patient facing media campaign in the south of England in Spring 2012 and dentists who are interested in being part of this campaign and have their practice featured should contact us on 01483 246303 for further details.

Still much to be positive about and here’s to a great 2012!

Penny Hardaker

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Health Seeking Activity is a Major Factor on Health Care Purchasing

Posted on January 23, 2012

The Center for Studying Health System Change in Washington, DC recently reported that 50% of American adults seek information about a personal health concern from a source other than their doctor. And nearly two in five American adults reported seeking health information on behalf of another person in the previous 12 months.

Health seeking activity seems to have declined modestly since the recession and in tandem with the decline in print media. However, ten years ago only 38% of American adults reported any health seeking activity.

The Center found that more information is sought on the Internet and less from print media. Those most actively searching for health information are the better educated. People with a graduate education are twice as likely as those with no high school diploma to seek health information (67% vs. 33%)—a disparity that has grown since 2007. The gap between the most- and least-educated groups is even wider for Internet use (52% vs. 11%).
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Fluoride for the High Risk Adult Patient – Does it Work?

Posted on January 19, 2012

The December 2011 issue of the Journal of Public Health Dentistry offers a systematic review of studies of fluoride’s preventive effect in high risk adults. 1 (Prevora’s therapeutic indication defines high risk with two examples: having 3 or more cavities at the start of the treatment plan or suffering from dry mouth).

Here are the findings of the systematic review:
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