The Afternoon Drill: July 13, 2011

A collection of dentistry and health related links/comments for your day.

Chain restaurants will make kids menus healthier

Parents seeking healthier restaurant meals for their kids can start to look beyond chicken nuggets and macaroni-and-cheese.

At least 19 restaurant chains — including Burger King, Chili's, IHOP and Friendly's — said Wednesday that they will include healthier options on their children's menus. At least 15,000 restaurant locations will focus on increasing servings of fruits and vegetables, lean proteins, whole grains and low-fat dairy. The items will have less fats, sugars and sodium.

Less healthy foods like burgers and fries will still be on the menu, but the restaurants say they will do more to promote healthier options. Chili's, for example, will highlight a chicken sandwich with a side of pineapple or mandarin oranges on their kids' menu. Burger King has recently reformulated children's chicken nuggets so they include less sodium, and employees taking orders will ask if customers want healthier apple fries instead of just the standard "fries with that?"

The effort is part of a new National Restaurant Association initiative to give kids more healthy options at restaurants and to make it easier for parents to find those options. Some of the items are already on menus, but restaurants will advertise them more prominently and flag the healthier menu items to make ordering easier.

To be part of the program, restaurants must include at least one kids' menu item that is 600 calories or less and meets other nutritional requirements. A side dish worth less than 200 calories must also be included.

"This could provide a great push toward healthier offerings at restaurants," said Robert Post, the Agriculture Department official in charge of developing the department's dietary guidelines, which came out earlier this year. Those urged Americans to eat less salt.

"We hope this is a trend toward new items and voluntary reformulations," Post said.
Chain restaurants large and small signing up for the initiative are Au Bon Pain, Bonefish Grill, Burger King, Burgerville, Carrabba's Italian Grill, Chevys, Chili's, Corner Bakery Cafe, Cracker Barrel, Denny's, El Pollo Loco, Friendly's, IHOP, Joe's Crab Shack, Outback Steakhouse, Silver Diner, Sizzler, T-Bones Great American Eatery and zpizza.

Hot Tea and Coffee May Lower MRSA Risk

New research shows that people who drink hot tea or coffee are about half as likely to have methicillin-resistant Staphylococcus aureus (MRSA) in their nasal passages as those who abstain, raising the prospect of a safe, inexpensive, and easily accessible way to decrease MRSA.

"In an effort to both prevent and treat MRSA, researchers have examined the antimicrobial effects of several commonly consumed plants and plant extracts," write the authors, led by Eric M. Matheson, MD, from the Department of Family Medicine, Medical University of South Carolina, Charleston. "What remains unclear is whether tea and coffee have systemic antimicrobial activity when consumed orally as beverages."

The study was published in the July/August issue of the Annals of Family Medicine.

Higher U.S. Medicaid Payments to Dentists Associated With Increased Rate of Dental Care Among Children

Children and adolescents from states that had higher Medicaid payment levels to dentists between 2000 and 2008 were more likely to receive dental care, although children covered by Medicaid received dental care less often than children with private insurance, according to a study in the July 13 issue of JAMA.

According to background information in the article, more than one-third of children are covered by public health insurance, primarily Medicaid and the Children's Health Insurance Program (CHIP). Coverage of dental care for children and adolescents covered by Medicaid and CHIP is required, although states have wide latitude in setting payment rates for providers including dentists, with these rates varying greatly by state. Medicaid recipients may not be able to access dental care if dentists decline to participate in Medicaid because of low payment levels or other reasons. Little is known about the effect of state dental fees on participation of dentists in the Medicaid program.

Sandra L. Decker, Ph.D., of the Centers for Disease Control and Prevention, Hyattsville, Md., conducted a study to examine the association of state Medicaid payment rates for dental care with the receipt of dental care among children covered by Medicaid. The study included data on Medicaid dental fees in 2000 and 2008 for 42 states plus the District of Columbia, and these data were merged with data from 33,657 children and adolescents (ages 2-17 years) in the National Health Interview Survey (NHIS) for the years 2000-2001 and 2008-2009.

Of the 42 states plus the District of Columbia considered in the analyses, the 2008 Medicaid dental fees were lower than the (inflation-adjusted) 2000 fees in 23 states. Payment levels to dentists in 2008 were higher than in 2000 in 19 states plus the District of Columbia. In five states (Connecticut, Indiana, Montana, New York, and Texas) plus the District of Columbia, payments increased by at least 50 percent between 2000 and 2008.

The researchers found that the probability that a child or adolescent had seen a dentist in the past 6 months varied by insurance source. In 2008-2009, children and adolescents covered by Medicaid were less likely (55 percent) than children with private insurance (68 percent) to have seen a dentist in the past 6 months, but were more likely to have seen a dentist than children or adolescents without insurance (27 percent). According to the author's, "children were about 6 percentage points more likely to have seen a dentist in 2008-2009 than in 2000-2001. … Those covered by Medicaid or CHIP were about 13 percentage points and uninsured children were about 40 percentage points less likely than children with private insurance to have seen a dentist."

Two Bay Area dentists came to the rescue of a gorilla with a toothache on Monday, San Francisco Zoo officials said.

Enjoy your day!