The Morning Drill: September 7, 2011

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

Living With a Smoker Increases Absenteeism in School Children, U.S. Study Confirms

Children who live in households where they are exposed to tobacco smoke miss more days of school than do children living in smoke-free homes, a new nationwide study confirms. The report from investigators at Massachusetts General Hospital (MGH) -- which finds these children have higher rates of respiratory illnesses that can be caused by second-hand smoke and details the probable economic costs of their increased school absence -- has been released in the online edition of Pediatrics.

"Among children ages 6 to 11 who live with smokers, one quarter to one third of school absences are due to household smoking," says Douglas Levy, PhD, of the Mongan Institute for Health Policy at MGH, the paper's lead author. "On a national basis these absences result in $227 million in lost wages and time for caregivers or their employers."

The authors note that one-third of U.S. children live with at least one smoker, and more than half of those aged 3 to 11 have detectable levels of a blood marker for tobacco exposure. Second-hand smoking has been shown to increase incidence of ear infections and several respiratory conditions, and school absenteeism is an accessible measure of serious illness in children. Earlier studies of the relationship between lost school days and household smoking have focused on local populations and did not evaluate the severity of the problem's impact. The MGH team analyzed data from the 2005 National Health Interview Study, an annual in-person survey of representative households nationwide.

Weight Loss Without the Hunger: Eat a Lighter Lunch, Scientists Say

Losing weight without a grumbling stomach or expensive liquid diet can be as simple as eating a lighter lunch, finds a new Cornell University study to be published in the October issue of the journal Appetite.

Participants who ate portion-controlled lunches did not compensate by eating more calories later in the day, leading researchers to believe the human body does not possess the mechanisms necessary to notice a small drop in energy intake.

"Making small reductions in energy intake to compensate for the increasing number of calories available in our food environment may help prevent further weight gain, and one way of doing this could be to consume portion-controlled lunches a few times a week," said doctoral student Carly Pacanowski, who co-authored the study with David Levitsky, Cornell professor of nutritional sciences and of psychology.

N.C. Medicaid cuts take hold in October

New cuts to health services for the poor take hold in October, with the elimination of eye exams and glasses for adults on Medicaid.

Medicaid recipients are receiving notices about reductions, eliminations or other changes to an array of health services in the next few months. The $354 million Medicaid cut in the state budget includes limits and other changes to services totaling $16.5 million.

In addition to getting rid of routine adult eye care and glasses, the state plans to limit payments for deep cleaning dental treatments for people who have gum disease to once every two years from once a year. Outpatient physical therapy, occupational therapy and speech therapy for adults will be limited to three visits a year.

Insurer's cuts leave dentists nursing $60 million toothache

Caring for your teeth costs more in Washington than just about anywhere else in the country, according to the state's largest dental insurer, which recently slashed payments to dentists for the first time in more than 50 years.

Washington Dental Service (WDS), a nonprofit that insures about 1.5 million patients in Washington, says the $60 million it expects to save in cuts to dentists has allowed it to offer a more affordable plan to small businesses.

Angry and dismayed dentists, hit with cuts of up to 15 percent or more, warn that the drastic reductions will hurt patients, who have grown accustomed to dentists who take time to focus on prevention and options, instead of just waiting until something hurts or breaks.

About 95 percent of the dentists in the state accept payments from WDS, but in the wake of the June 15 cuts, some have dropped the insurer, and many say they're still considering doing so.

Dentists, most of whom own their own clinics, say they have no control over rising overhead costs and warn they likely will have to make drastic changes in their practices.

"Never in my 23 years in practice has there been a bigger threat to the way I take care of my patients," said Dr. Chris Pickel, a Northgate-area dentist and immediate past president of the Seattle-King County Dental Society.

"This is a big tipping point right now," Pickel said. "It forces dental practices to go to a volume-based system, where you see more patients per day," limiting time for proactive, preventive care.

Enjoy your morning!