According to Kaiser Family Foundation, 37 million Americans do not have dental insurance. As a result, dental practices have begun offering their own personalized and affordable dental membership plans to patients. In total, less than 20% of dental practices currently have memberships. However, this figure is growing rapidly due to the adoption of dental membership plan software.

But how do these plans work? And are they a worthwhile investment for dental practices?

Dental practices should weigh the costs and benefits of membership plans and become familiar with the software tools that enable them.

Dental Membership Plan Overview

Dental membership plans are similar to other subscription-based services that you are familiar with, such as Netflix or Amazon Prime. Patients enroll in membership programs where they pay subscription fees on a monthly or yearly basis. In return, patients receive care at a discounted rate.

Typically, patients pay $20 to $30 per month for their membership plans. In return, they are eligible for two free cleanings per year, and receive 10-20% off additional services. By increasing loyalty and creating a new revenue line, membership plans can become lucrative for dental practices.

Dental Membership Plan Benefits

Dental membership plans offer a variety of benefits for dental practices and their patients. The most notable benefits are listed below.

Cuts out the insurance middleman

Both dentists and patients can agree that dealing with insurance companies is a hassle. Many dentists are frustrated with filing claims while insurance companies eat into their bottom line. For patients, dental insurance is expensive and restricts access to practices that are in-network. Dental membership plans remove insurance companies from the equation.

With the membership model, dentists dictate their own fee schedules, and receive payments directly from their patients. Dental practices end up making more money and are able to pass the savings along to their patients.

Attracts uninsured patients

Uninsured patients often don’t receive the care they need because they perceive dental care to be too expensive. Who could blame them? Insurance companies often have opaque pricing with high deductibles, premiums, and copays.

Dental membership programs have transparent pricing with discounted rates. Membership plans are far more attractive to uninsured patients and often lead to higher case acceptance rates.

Reduces time spent on claims

As we mentioned before, filing insurance claims steals precious time from you and your front-office staff. Maintaining high claim acceptance rates is difficult, and every dental professional is familiar with being on hold with insurance companies and dealing with rejected claims. Dental membership plans lift this burden from your practice, so you can focus on providing excellent care for your patients.

Dental Membership Plan Software

A barrier to offering dental membership plans is the notion that implementation is a time-consuming process. However, dental membership plan software allows dentists to quickly set up and efficiently maintain membership programs.

Dental membership plan solutions automate important processes and manage the membership programs on behalf of dental practices. This allows dentists and front-office staff to focus on more important tasks such as offering exceptional care for patients. The most important features found in dental membership plan software are listed below.

The most popular dental membership plan solutions are Kleer, Dental HQ, and illumitrac. In general, these solutions cost a few hundred dollars a month. The software is typically priced as a flat fee per location, or a few dollars per member per month.

Configurable dental membership plans

Solutions like Kleer allow practices to create custom care plans that fit their needs. Practices can set their own pricing and treatments to include in the plans. Practices can also offer discounts for groups and families.

Automatic payment collection

Dental membership plan solutions often include features that allow practices to automatically receive recurring payments from their patients. This reduces administrative workload and eliminates the need for front-office staff to chase down outstanding balances. This is likely the most important feature found in membership plan software from a financial perspective.

Analytics

Dental membership plan software typically also includes an analytics dashboard that tracks revenue and monitors your performance. Tracking key metrics helps increase memberships and promotes practice growth.

Bottom Line

Dental membership plans are gaining momentum in practices across the country. This movement is being catalyzed by dental membership plan software that makes it easier to implement and manage an in-house plan.

In general, starting a dental membership plan is a better idea for dental practices with a large uninsured population, or those looking for a new revenue stream. Practices with less than 250 patients are better off managing their in-house plans themselves. Larger practices with over 250 patients will likely benefit from using dental membership plan software, which costs a few hundred dollars per month.

Fifty or so years ago, the owners of Listerine — the mouthwash with “the taste people hate twice a day” — claimed their magic but foul-tasting elixir could cure numerous maladies, including sore throats, the common cold, tooth decay and gum disease.

The Federal Trade Commission began putting an end to those false, unsubstantiated claims in 1978, when it ordered the company to spend $10 million on an ad campaign informing the public that, “Contrary to prior advertising, Listerine will not help prevent colds or sore throats or lessen their severity.”

So, the results of two recent peer-reviewed studies that found Listerine and an array of cosmetic and therapeutic mouthwashes kill the novel coronavirus in the laboratory should be approached cautiously.

The studies are in vitro, in glass, in the test tube, in the petri dish, and we won’t know if these compounds work on actual living organisms, in this case human beings, until in vivo studies are done.

Nevertheless, for dentists, dental hygienists and other dental healthcare providers, there’s plenty to celebrate in the studies, since they both validate some practices already put in place by dental offices when the pandemic took off in the United States last March and point the way forward for future research.

In July, The Journal of Infectious Diseases published a study by multiple authors, “Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2.”

In September, The Journal of Medical Virology published “Lowering the transmission and spread of human coronavirus.” Both studies put cosmetic and therapeutic mouthwashes available over the counter and by prescription to the test.

The former study tested the effects of various mouthwashes on SARS-CoV-2. The latter study tested mouthwashes as well as several nasal rinses against human coronavirus, HCoV, which costs less to replicate than SARS CoV-2 and has a similar fatty, protective covering.

Cracking that fatty covering is what virucides do, and both studies suggest that the common household chemical hydrogen peroxide, H₂O₂, may be an effective virucide for eradicating novel coronavirus in oral cavities.

“The three products with H₂O₂ as their active ingredient all demonstrated similar abilities to inactivate HCoV,” the Journal of Medical Virology study found. “Crest Pro?Health decreased infectious virus by 99.9 percent to more than 99.99 percent; again, the contact times used made little difference.”

The contact times in the study were 30 seconds, 1 minute and 2 minutes. Theoretically, gargling with a diluted hydrogen peroxide solution for just 30 seconds may reduce novel coronavirus in the patient’s mouth and throat by 90% to 99.9%.

The American Dental Association concurs. Since the onset of the pandemic it has advised dentists to require patients “rinse with 1.5 percent hydrogen peroxide or commercially available rinses that contain 1.5 percent hydrogen peroxide just prior to beginning treatment.”

Lori Gordon Hendrick, MS, RDH, CDA, CDT and a dental office infection control consultant offered more details about hydrogen peroxide on the Registered Dental Hygienist website last March.

“The concentration of any rinse used should be at least 1.5 percent,” she wrote. “Patients should rinse for at least 1 minute. Over-the-counter peroxide is typically 3 percent; therefore, one should dilute 1-part hydrogen peroxide to 2-parts water. In the dental industry, we have several products [that contain H₂O₂]. Two examples are Colgate Peroxyl and Listerine Whitening Mouthrinse, both of which contain 1.5 percent peroxide. Also available is EverSmile which contains a 3.8 percent concentration of peroxide.”

Hendrick also endorsed oral rinses containing the active ingredient povidine-iodine, or PVP-I. Similarly, the study published by the Journal of Infectious Diseases found that a commercially available mouthwash containing PVP-1, Iso Betadine 1 Percent, was one of three products tested that “significantly reduced viral infectivity to undetectable levels.”

Somewhat unbelievably, given the dubious medical and dental claims made in its past, Listerine, the old-school nasty tasting stuff (not the brand’s numerous spinoff products), may be one of the most potent SARS-CoV-2 virucides on the market according to both studies.

“Listerine Antiseptic is an alcohol?based eucalyptol, menthol, methyl salicylate, and thymol formulation that historically has claimed numerous antimicrobial properties,” notes the Journal of Medical Virology study. “It currently lists only a claim to kill germs that cause bad breath. Our tests show that it is highly effective at inactivating HCoV in solution. Even at the lowest contact time of 30 seconds it inactivated greater than 99.99 percent of HCoV.”

Critics of this study have pointed out it used HCoV, human coronavirus, which isn’t a perfect stand-in for SARS-CoV-2. But the study published by the Journal of Infectious Diseases did use SARS-CoV-2 and expressed similar findings about Listerine.

“In agreement with our observation, different studies using Listerine observed antiviral activities specifically against enveloped viruses, implying an impact on the viral lipid envelope,” the study found. “The in vivo effects of the oral solutions require further analysis during clinical studies.”

The study concludes by noting that said in vivo experiments are already in the works.

Oral and naval cavity rinses — a 1% solution of Johnson and Johnson’s Baby Shampoo up the nose has proved effective at treating certain rhinoviruses — by definition are only a partial solution. Novel coronavirus thrives throughout the respiratory system and can hide in places medicine can’t yet reach.

In a story responding to the studies, The New York Times put it this way:

“Relying on mouthwash or a nasal rinse to rid the body of infectious virus would be about as futile as trimming the top of a cluster of weeds, paying the roots little mind, and expecting the garden pests to disappear.”

Still, both studies end on an upbeat note.

“Nasal rinses and mouthwashes, which directly treat the major sites of reception and transmission of HCoV, may provide an additional level of protection against the virus,” states the study published in The Journal of Medical Virology.

“While clinical trials will be necessary to confirm the virucidal potential of these products and assess their ability to limit transmission of HCoV within the general population, in the current manuscript we have demonstrated here that several commonly available healthcare products have significant virucidal properties with respect to HCoV.”

The study published in The Journal of Infectious Diseases, which did use SARS-CoV-2 in its experiments, ends with a forward-looking statement.

“Our findings clearly advocate the evaluation of selected formulations in clinical context to systematically evaluate the decontamination and tissue health of the oral cavity in patients and healthcare workers to potentially prevent virus transmission,” it states.

Let the experiments begin. In the dental setting, it seems likely that the SARS-CoV-2 viral load—the risk to workers in the dental workplace — has been lowered by requiring patients to rinse with hydrogen peroxide and povidine-iodine solution before dental procedures.

Like wearing proper personal protective gear and maintaining social distance, rinsing your oral and nasal cavities out with a virucidal solution may become yet another tool for stopping the spread of the pandemic.

Not that Listerine, now owned by Johnson and Johnson, dares make such a bold claim. On its COVID-19 FAQ page, it makes it plainly clear that the only thing Listerine Antiseptic can do is kill “99.9% of germs that cause bad breath, plaque and gingivitis.”

“Listerine mouthwash has not been tested against the coronavirus and is not intended to prevent or treat COVID-19,” the company continues. “Consumers should follow the preventive measures issued by the World Health Organization including washing hands frequently, maintaining social distance and avoid touching your eyes, nose and mouth.”

Sound advice.

Last month, the World Health Organization recommended delaying “routine nonessential oral health care … until there has been a sufficient reduction in COVID-19 transmission rates from community transmission to cluster cases.”

The WHO was responding in part to the growing body of scientific evidence indicating novel coronavirus can be spread by respiratory droplets smaller than five microns in diameter known as droplet nuclei or, in more general terms, aerosols.

That’s concerning because aerosol-generating procedures are common in the dental workspace. According to the Centers for Disease Control, “Commonly used dental equipment known to create aerosols and airborne contamination include ultrasonic scaler, high-speed dental handpiece, air/water syringe, air polishing, and air abrasion.”

In a study published in May on the National Institutes of Health website and conducted by the School of Medicine at China’s Zhejiang University, “Possible aerosol transmission of COVID-19 and special precautions in dentistry,” researchers cited data demonstrating that aerosol generating procedures can transmit pathogens.

“When combined with bodily fluids in the oral cavity, such as blood and saliva, bioaerosols are created,” the study states. “These bioaerosols are commonly contaminated with bacteria, fungi, and viruses, and have the potential to float in the air for a considerable amount of time and be inhaled by the dentists or other patients.”

The study noted that so far, there have been “no reported cases of COVID-19 transmission in the dental setting.”

In the United States, that’s in part due to interim guidelines issued by the American Dental Association and the CDC that urged for the reduction of aerosol-generating procedures and initially called for delaying nonessential dental care, just as the WHO did last month.

But the ADA was quick to “respectfully yet strongly disagree” with the WHO’s call to delay “routine” care now, as many dental offices have successfully reopened.

“Millions of patients have safely visited their dentists in the past few months for the full range of dental services,” ADA President Chad P. Gehani said the day after the WHO’s announcement. “With appropriate PPE, dental care should continue to be delivered during global pandemics or other disaster situations.”

The WHO, ADA and CDC are more often in agreement than not when it comes to oral healthcare and COVID-19. The ADA and CDC have cautioned against using aerosol-generating procedures since May and are in a sense ahead of the curve.

“Current data do not support long range aerosol transmission of SARS-CoV-2, such as seen with measles or tuberculosis,” the CDC states. On the other hand, “Short-range inhalation of aerosols is a possibility for COVID-19, as with many respiratory pathogens.”

That’s especially true in the close confines of the oral healthcare setting, where many of the primary tools used generate bioaerosols. Indicative of the situation’s urgency, both the ADA and the CDC advise avoiding all aerosol generating procedures if possible, during the pandemic.

“Avoid aerosol generating procedures whenever possible, including the use of high-speed dental handpieces, air/water syringe, and ultrasonic scalers,” the CDC’s current guidelines state. “Prioritize minimally invasive/atraumatic restorative techniques (hand instruments only).”

If aerosol generating procedures can’t be avoided, the CDC recommends using “four-handed dentistry, high evacuation suction and dental dams to minimize droplet spatter and aerosols.”

As more evidence of COVID-19’s airborne potential has come in, the CDC has modified the interim guidelines. In late August, it issued new personal protection equipment recommendations for dental healthcare personnel in areas with no to minimal community transmission and areas with moderate to substantial community transmission.

Dental healthcare workers in areas with no to minimal community transmission are now advised to “wear a surgical mask, eye protection (goggles or a face shield that covers the front and sides of the face), a gown or protective clothing, and gloves during procedures likely to generate splashing or spattering of blood or other body fluids. Protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and sprays.”

Dental healthcare workers in areas of moderate to substantial community transmission are advised to take further precautions, especially if they’re performing aerosol generating procedures.

“During aerosol generating procedures DHCP should use an N95 respirator or a respirator that offers an equivalent or higher level of protection such as disposable filtering facepiece respirators, powered air-purifying respirators, or elastomeric respirators,” the new guidelines state.

The recommendation to wear an N95 respirator, its equivalent or better also applies to dental healthcare workers working with patients suspected or confirmed to have COVID-19.

“Airborne transmission from person-to-person over long distances is unlikely,” the new CDC regulations state. “However, COVID-19 is a new disease, and we are still learning about how the virus spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for hours, and on some surfaces for days under laboratory conditions. SARS-CoV-2 can be spread by people who are not showing symptoms.”

Sometimes those people are patients, and both the CDC and the ADA advise dentists to check their patients for fever and other possible COVID-19 symptoms at the office door. Patients should be encouraged (but not forced) to wear at least a cloth mask to prevent spread of the virus. The CDC even recommends testing patients for coronavirus if quick test results are available.

The economy witnessed unexpected job growth in May as state and local economies began to reopen from the pandemic shutdown. In particular, medical practices and dental offices were key drivers of this finding that surprised economists.

According to the May 2020 Bureau of Labor Statistics (BLS) economic report, healthcare — including dentists — added more than 310,000 jobs during the month. Dental offices experienced job rebounds at rates unlike any in the sector.

The BLS says the healthcare sector grew to more than 15.2 million jobs. This represents a 2% rise, up from 14.9 million. Physician practices increased employment by at least 51,000 jobs compared to the previous report.

At the start of May, Grant Thornton, an independent audit, tax, and advisory firm,reported that posting for new jobs on all the major job websites fell between 30% and 40% in March and April. Some sites, they saw, a drop in posting as early as late February when the tech giants canceled off-site meetings and major conferences to stem contagion.

The halt spanned almost all industries across all income categories. Most notably, healthcare saw job losses, despite the health crises bought on by the pandemic. These losses were the result of the cancellation of all elective surgeries as health systems responded to COVID patients.

“The fear of going to dental and doctor’s offices and contracting COVID-19 prior to national lockdowns in March had already triggered the largest-ever drop in healthcare jobs in a single month,” Grant Thornton reported at the time.

An April 21 report in The Hill found that more than 4 in 10 polled Americans say they had their wages cut or lost their jobs altogether because of the pandemic. The Pew Research Center study found 28% of respondents lost their jobs or been laid off because of the outbreak. A third took pay cuts. A combined 43 percent said one or both applied to them.

As mentioned previously, dentist office employees were the biggest winners in the recent jobs report. Jobs increased here by at least 244,000, compared to April.

But hospital employment declined by 26,000 in May. Furloughs and firings continued for some health systems because of low patient volume and the cancellation of surgical procedures dating back to March. This is starting to change, however, as some hospitals are beginning to resume elective procedures.

Nursing care facilities also lost more than 36,000 jobs from April to May. As the Trump administration announced, the reason for this is that more than 32,000 nursing home residents have died because of COVID-19.

In May, the unemployment rate fell to 13.3%, after touching 14.7% in April. The total number of unemployed was 20.985 million.

April’s unemployment rate was the highest since the Great Depression. In 1933, the unemployment rate reached a record of 24.9%. Unemployment remained above 14% for nine years, from 1931 to 1940. April’s unemployment rate reached that level in just a month.

During the 2008 Great Recession, unemployment peaked at 10% in October 2009. In 1982, unemployment rose to 10.8%.

Dental practices across the nation are just one category of small businesses that have suffered, both economically and logistically, due to the near-national shutdown in response to the COVID-19 pandemic. And as lawmakers are working on the next relief package, the American Dental Association, on behalf of its 163,000 members, is urging Congress to include language to assist the dental industry in the process of recovery.

The ADA is making a few key recommendations to legislators:

1. Increase flexibility within the Paycheck Protection Program. ADA representatives are asking that the loan forgiveness guidelines allow individual small businesses to make their own decisions regarding payroll and staffing based on individual plans to reopen.

Dentists would like to see Paycheck Protection Program (PPP) loan funds allowed for purchasing additional personal protective equipment (PPE), making safety improvements to offices, and qualifying for tax credit.

2. Allow nonprofit dental and medical organizations to have access to the Paycheck Protection Program or future small business loan programs.

3. Execute better oversight for the distribution and loan forgiveness process in the Coronavirus Aid, Relief, and Economic Security (CARES) Act for PPP loans to guarantee that only those small businesses that were economically distressed as a result of the pandemic receive the funds and forgiveness.

4. Ramp up the production of PPE with more focused distribution to healthcare workers, including dentists.

5. And a big one:Extend the Department of Health and Human Services’ authority to allow licensed dentists to conduct FDA-authorized COVID-19 diagnostic tests until the end of the year.

This last recommendation is an important one as it would help alleviate the burden of hospital emergency rooms across the country who are coping with the pandemic.

Dentists can visit the Legislative Action Center to contact their legislators today regarding these recommendations. For the latest information on COVID-19, visit ADA.org/virus.

To help assist and guide dentists across the nation who are reopening their practices as state mandates are lifted, the ADA issued an updated statement and interim guidance April 18 on the specific personal protective equipment recommended in order to practice during the COVID-19 pandemic as well as guidance on ways to minimize the risk of virus transmission.

The ADA is regularly communicating with the Federal Emergency Management Agency and other relevant organizations to advocate that dentists should be prioritized for PPE as essential healthcare workers.

Beginning on March 16, the governing organization asked dentists nationwide to postpone non-urgent dental procedures through the end of April in order to help slow the spread of COVID-19. The recommendation was also made to conserve essential PPE for medical frontline colleagues and first responders. These measures would also keep those patients away from overburdened hospital emergency departments. In other words, emergency dental cases could still be seen in dental practices.

According to the April 18 statement, “The ADA recognizes that local or state government decisions regarding closures, including restrictions regarding elective health care, supersede ADA recommendations. In addition, local and state health departments, state dental societies and, in some cases, large urban local dental societies may better understand local disease transmission rates and conditions and make more informed recommendations regarding elective dental care availability.”

In his daily press conference, President Donald Trump recently indicated that many states will be able to reopen by May 1. On April 16, he shared federal guidelines for loosening some restrictions. State and local governments in some states are now considering reopening certain businesses considered “essential,” which include dental practices, as they slow-roll their communities back into normal operations.

The ADA statement sums it up this way: “The longer dental practices remain closed to preventive care and treatment for early forms of dental disease, the more likely that patients’ untreated disease will progress, increasing the complexity and cost for treatment down the road. The safety of patients, dentists and dental team members has been and always will be ADA’s utmost concern.”

With its recently formed ADA Recovery Task Force, the ADA is adding additional resources regularly. You can find all ADA guidance at ADA.org/virus.

As with most medical practices in America today, the vast majority of dental practices are limiting care to urgent and emergency cases to limit exposure to COVID-19, preserve personal protection equipment (PPE) and reduce the burden on the healthcare system at large.

But as these recommendations and restrictions are put in place, some dental practices might not be sure about what qualifies as urgent and emergency treatment — or what to do once these patients come into their offices.

As you know, oral health is closely connected to overall health. So, if a patient has a dental emergency, the possibility does exist that it is potentially life-threatening and requires immediate attention from a dental professional. Postponing non-essential procedures during this time of social distancing allows dentists to focus on patients who need emergency care during the coronavirus pandemic of 2020.

If you haven’t already done so, communicate to your patient base that patients should postpone all non-emergency dental examinations, including but not limited to routine cleanings, aesthetic dental procedures and restorative dentistry.

Reserve your appointments for true dental emergencies. These can include people experiencing severe dental pain, those who have dental infection symptoms such as bleeding and swelling and/or those experiencing a dental infection-related fever. Let patients know if they are experiencing any of these symptoms, they should contact your office immediately for an emergency appointment.

If your clinical team needs help determining whether or not a patient’s issue is emergent, consider the following list of questions to ask patients before scheduling an appointment, per American Association of Endodontists President Keith V. Krell:

• What symptoms are you experiencing?
• Do you have a fever?
• Is your tooth sensitive to hot and cold foods?
• Are you experiencing bleeding or swelling in your mouth, gums, etc.?
• On a scale of 1 (lowest) to 10 (highest), how much pain are you experiencing in your tooth?
• Is the pain spontaneous, constant or provoked by temperature, chewing, etc.?

If a patient’s issue is deemed to be a true dental emergency that needs to be addressed, the following tips can help make sure everyone involved — your clinical team and your patients — stay safe during an appointment.

• Ask screening questions about travel history and signs or symptoms of infection.
• If a patient is experiencing signs of acute respiratory illness upon arrival, patient should be given a disposable surgical mask and placed in a single-patient room with the door closed.

For more information on recommendations on managing treatment during the coronavirus outbreak, visit the website of your local state authorities as well as:

Is America still the superpower it was in years past? We’ll let world leaders and political commentators battle that one out, comparing the military might and economic muscle of the U.S., China and Russia.

But in the field of dental education, America doesn’t seem to be shining as brightly as some of our global neighbors. This year’s QS World University Rankings shows a clear message that some of the world’s best dental education can be found in other parts of the globe.

While the United States had 12 schools in its top 50, the United Kingdom had seven, including King’s College London Faculty of Dentistry, Oral & Craniofacial Sciences in the top slot.

The survey company ranks schools based on their academic reputation, taking into account the responses of nearly 95,000 academics worldwide. It also uses employer reputation, based on nearly 45,000 survey responses from global graduate employers. And, it uses research citations per paper and “h-index,” which measures the productivity and impact of published work that comes out of that institution.

The Academic Centre for Dentistry Amsterdam, which tied with King’s College London for second place last year, took second by itself this year. The University of Michigan School of Dentistry was third overall and the top American school, moving up from fifth place last year. Fourth and fifth place went to the University of Hong Kong and Harvard University, respectively.

The other American dental schools that made the cut to be included on the distinguished list include:

Take away

American undergrads planning to pursue a career as a dentist may want to consider studying abroad when selecting the dental schools where they plan to send their applications for enrollment.

Sealants prevent cavities in kids. Science says so.

So why is the Health Resources and Services Administration (HRSA) proposing a watered-down measure, titled “Primary Caries Prevention Intervention as Offered by Primary Care Providers, Including Dentists,” that would take the place of current recommendations on sealants for kids?

That’s what the American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) would like to know!

Leaders from both organizations sent a letter Aug. 27 to the HRSA in response to a proposed change to the current sealant measures.

“We are writing to express our concerns about the proposed replacement of the Dental Sealants for Children Between 6-9 Years measure,” ADA President Jeffrey M. Cole, ADA Executive Director Kathleen T. O’Loughlin, AAPD President Kevin Donly and AAPD Chief Executive Officer John S. Rutkauskas wrote in the letter. “Research has shown that sealants are effective in preventing occlusal carious lesions in the molars of children when compared with controls without sealants.”

The letter points to an evidence-based clinical practice guideline released in 2016 by the ADA and AAPD that found sealants could minimize the progression of cavities in permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes.

“There is in fact evidence to suggest the superiority of resin-based fissure sealants over fluoride varnishes applied to prevent decay in permanent molars,” the letter stated. “While both topical fluoride, as well as dental sealants, are important caries preventive modalities, we fail to see the agency’s rationale for removing the focus on improving sealant rates, especially given the improvement health centers have made.”

As reported by 1,362 administration-funded health centers, their performance improved more than 10% between 2015 –– when the sealant measure was first adopted –– and 2018.

Nearly 53% of children 6 to 9 years old who are at an elevated risk for caries received the recommended sealants. Thirty-six states also have performed better by at least 5% on the measure from 2015 to 2017.

The HRSA explained its rationale in a letter to health centers, stating the fluoride varnish measure would increase the target population from high-risk children who are 6 to 9 years old to children and adolescents as old as 20 and include oral health preventative measures that health centers without dentists can employ.

“The application of fluoride varnish to the teeth of children reduces the risk of development of caries,” the administration stated. “Increasing the use of non-dental providers (i.e., primary care providers) providing fluoride varnish to their patients can reduce the incidence of caries and promote better oral health.”

However, the fluoride varnish measure would track only one application of varnish during the measurement period, contrary to evidence-based guidelines that state topical fluoride should be applied every three to six months in children at an elevated risk for cavities.

The ADA and the AAPD are encouraging the HRSA to only consider metrics that are supported by strong scientific evidence and further tested for validity, feasibility, reliability and usability. The officials noted the sealant measure was developed and tested by the Dental Quality Alliance, an entity convened by the ADA that maintains the measure through a periodic review process to align it with emerging science and implementation experience.

“The use of measures that have not been adequately tested undermines confidence in measures among providers and consumers of health care,” the letter concluded.

Updates on this issue can be found at ada.org.

Volpe Research Center has been famous for developing materials, tools and technologies used in the field of dentistry for the last 90 years and counting. It’s kind of a big deal. More than 200 products used in dental practices all over the world have come out of the Volpe labs. Some of science’s brightest minds work there.

Today, of the Volpe Research Center’s six principal investigators — those who manage and direct all the projects and research — four are women. That’s some serious girl power.

These VRC scientists are focused on developing improved “smart” dental materials such as dental composites with superpowers. Well, sort of.

These “smart” materials they are developing are resistant to breakdown, capable of self-healing and have antimicrobial properties. They are also developing improved sensors to help early detection of dental decay and periodontal disease.

While not dentists, these women are playing a significant role in how dentists work and, ultimately, the oral health of patients across the globe. Imagine a faster and more accurate way to assess a person’s health such as risk of heart disease and diabetes through inspecting a person’s mouth. That’s just one of the amazing projects these scientists are working on.

“We’re designing and testing sensors that we can one day use in people’s mouths to detect a variety of diseases,” said Nicole Ritzert, Ph.D., lead researcher on that project. “I’m not a biologist or dentist, but I know how to measure relevant parameters such as pH. I’m able to use my expertise to help fill in gaps in oral health research.”

Another project on the radar of these scientists is researching the effects of e-cigarette vapor, especially the sweet-flavored e-liquids, on oral health. “Based on the biological and physiochemical data, we found that certain e-liquid ingredients interact with hard tissues of the oral cavity in such a way that resembles high-sucrose candies and acidic drinks,” Shinae Kim, Ph.D., said.

Dr. Kim has an extensive background in optics, electronics, nano/micro-fabrication and microfluidics. She first joined the VRC as a postdoctoral fellow in February 2017 before becoming a principal investigator in April.

In addition, by offering scientific data and evidence, dentists can better help their patients understand the potential harmful effects of e-cigarette flavors.

“[The work at the VRC] does not start with a mere intellectual curiosity, but we do research to help dentists,” Dr. Kim said. “There, it is very attractive to me to conduct more practical and directly usable research. It’s different from other research institutes or universities.”

Volpe Research Center is truly a unique place because of the center’s interdisciplinary research areas of engineering, physics, chemistry and dentistry.