The Morning Drill: December 12, 2011

At the Los Angeles Auto Show a few weeks ago

Good Morning!

It is a rainy Monday here in Southern California today. Winter is arriving.

On to today's dentistry and health headlines.

Dentists to Receive Minor Surgery Training to Help Save NHS Money

Dentists in the Bolton area are to receive training in minor surgery, in a move that will save NHS Bolton around £1 million.

At the moment, patients are visiting hospitals for operations and procedures, which could be carried out by dentists and is contributing to huge hospital care bills. The cost of treating a patient in hospital is up to ten times higher than treating them in a health centre and health bosses have consequently decided to provide additional training for dentists so that they can provide surgery in the future.

Health bosses will provide training for dentists at a new centre. Procedures will include extractions and minor surgery and patients can also be referred to the centre by their dentists if they feel that they cannot carry out the operation themselves.

NHS Bolton has confirmed that the range of treatments available will constitute those that “can and should be done” by dentists at a dental surgery, rather than doctors in a hospital setting.

UCLA researchers identify new method for generating stem cell-like cells from human skin

Researchers from the UCLA School of Dentistry investigating how stem cells can be used to regenerate dental tissue have discovered a way to produce cells with stem cell–like characteristics from the most common type of human skin cell in the epidermis.

These skin cells, called keratinocytes, form the outermost layer of skin and can be cultured from discarded skin tissues or biopsy specimens.

The findings, published in the Nov. 4 edition of the peer-reviewed Journal of Biological Chemistry, may be beneficial for individuals with limited sources of endogenous stem cells.

What types of noncarious lesions are most often restored?

What types of noncarious lesions do dental practitioners most often choose to restore, and why?

That was the question addressed in a new study in the Journal of the American Dental Association (December 2011, Vol. 142:12, pp. 1368-1375).

Researchers from the University of Florida (UF) College of Dentistry in Gainesville analyzed data collected by a dental practice-based research network (DPBRN) over 30 months to quantify the reasons restorations are placed in noncarious lesions and assess the characteristics of the tooth, patient, and practitioner performing the restorations.

"The various types of NCTDs [noncarious tooth defects] can affect tooth sensitivity, dental plaque retention, structural integrity, and pulpal vitality, which also may be conditions that require placing a restoration," the researchers wrote. "Thus, the decision to restore NCTDs may be not only based on the need to replace lost tooth tissue, but also aimed at preventing further damage or based on aesthetic reasons."

GOP Bill Calls for 2-Year Medicare 'Doc Fix' With 1% Raise

House Republicans today unveiled a "doc fix" for the Medicare reimbursement crisis that would not only avert a 27.4% pay cut on January 1 but also raise rates by 1% annually through 2013.

The measure is part of an omnibus bill that would, among other things, extend unemployment benefits as well as a temporary cut in the Social Security payroll tax through 2012. House Republicans, who command a majority in that chamber, intend to vote on the bill next week. If passed, the bill faces Democratic opposition in the Senate, which that party controls, and a threatened veto from President Barack Obama.

Earlier this week, House Republicans were considering a doc fix that would merely freeze Medicare rates over 2 years. The Congressional Budget Office (CBO) had put its cost at $38.6 billion over 10 years.

The latest doc fix from the GOP is more generous, with a 1% raise in both 2012 and 2013. The CBO priced that at $38.9 billion.

The bill requires the Medicare Payment Advisory Commission, the Governmental Accountability Office, and the Department of Health and Human Services to help Congress devise a new way to set Medicare rates for physicians. The method used now — the sustainable growth rate (SGR) formula — is what triggered the 27.4% cut scheduled for 2012.

Organized medicine as well as the GOP Doctors Caucus, which consists of 21 physicians and other clinicians in the House, has lobbied hard for a permanent repeal of the SGR formula. Its cost — almost $300 billion for merely freezing rates through 2021 — appears too expensive for a budget-minded Congress to stomach right now, especially because fiscal conservatives insist that every increase in spending be offset elsewhere in the federal budget.

Enjoy your morning!