Monday, November 23, 2015

Dr. Rubinstein appointed to faculty at University of Rochester's Eastman Dental Institute

     We're proud to announce that our practice has been designated a research site by the National Practice Based Research Network. This allows our practice to participate in active research efforts to improve treatment outcomes in oral and general health.
      Under a grant from the National Institute of Dental Research and the N.I.H., the network allows us to combine forces with other dental practices to create powerful and efficient research programs. The opportunity for patients to participate is, of course, completely voluntary and the information collected is kept strictly confidential.
     The D.P.B.R.N. network studies create a valuable opportunity for us to not only remain at the cutting edge of oral health treatment, but to give our patients the advantages of the most current and studied treatments in the practice of Dentistry.

Monday, August 17, 2015

Fluoride is not just for kids !

           Did you think fluoride treatments were just for  kids?  Should you consider supplemental fluoride treatments? The answer is "maybe". After all, most dental insurance only covers in-office fluoride treatments for children under the age of 18.
Unfortunately, just because we're adults, that does not mean we've become magically immune to tooth decay (Caries). And just because your insurance plan doesn't pay for it, that doesn't mean it wouldn't be a benefit to you.  Adults who have an elevated risk for caries should have that risk assessed, and additional fluoride can be a very effective preventive intervention.

There are several reasons an adult might require extra fluoride. Many of the prescription medications we take can reduce saliva flow or otherwise create dry mouth.  Patients who have undergone radiation treatment for cancer also have significantly decreased salivary flow, because radiation damages the salivary glands. Saliva neutralizes acids in the mouth, and also contains antibodies and other immune system factors, so any reduction in saliva increases the risk of tooth decay.

Adults often experience gum recession, which exposes part of the root surface of teeth. These areas are softer than the hard enamel at the top of the tooth, which makes them more susceptible to decay.

Today many people opt for orthodontic treatment (braces) as adults. Braces make it more challenging for patients to maintain good oral hygiene. Just ask your kids! Fluoride can keep the teeth strong and cavity-free even with the obstacle of orthodontic appliances.
Have you had a restoration done within the last year due to new decay? If you have, that puts you at a higher risk for cavities. Fluoride treatments are a great way to prevent more cavities in patients who are already prone to them.

Fluoride can also help with the growing problem of sensitive teeth. Diets high in acidic foods and beverages, general gum recession, and increased use of whitening products all tend to produce tooth sensitivity. Fluoride treatments re-mineralize tooth enamel and reduce that sensitivity.

If one or more of these conditions applies to you, consider requesting a topical fluoride treatment.

Some Helpful Informatiuon from the American Dental Association about Fluoride Supplementation.

Tuesday, July 7, 2015

Practice Based Research : The Future of Dentistry

     There are some big changes happening in the world of dental and medical research. Technology affords our patients new and better ways to access the information they can use to improve their health. One of the most significant is "practice based research". This is a model in which hundreds of doctors in private practices throughout the country participate in a research project together, under the guidance and support of a national organization (in our case, the National Dental Practice Based Research Network).
     In my practice, we have been participating in this type of research for several years now. We want the dental care we provide to be "evidence based". That seems obvious. But how do we decide what kinds of evidence we should be using, and how we should be collecting and evaluating it? What does it mean when we say a treatment or a cure is based on "research"? 
     Historically, basic dental research in this country was conducted in teaching hospitals and academic medical centers, and a much of it still is. But full time academics often conduct their studies far from the realities of private practice, and this can hinder their vision of the ultimate goal of research: improving dental practice and patient outcomes.

"Practice based" research is a welcome and growing trend in the profession of dentistry.

Thursday, January 8, 2015

Your personal private health information is valuable. And it's YOURS. Protect It !

      When we visit the doctor these days, much of our health information is collected, transmitted and stored electronically. We might enter our medical history into an iPad.  Our prescriptions are often sent directly to our pharmacies electronically, and results of our lab tests might be made available for us to view online, through an online patient portal. Even our appointment reminders may be communicated via text or email. 
     You have probably noticed some of these trends, and you can expect them to continue. Here in New York for example, there will be no paper prescriptions permitted after March of 2016. Electronic prescribing will be the standard and the rule. Very convenient and efficient, many of these changes offer us enhanced efficiency, convenience and safety.

 HOWEVER....... some of these advances also conceal potential threats to the safety and security of our information. If huge corporations like Target, Sony and Microsoft can suffer a data breach, how safe can our health information be?  Here's some interesting info about the Sony breach as it relates to health information.
     This is something to be aware of any time you hand over your insurance card or your credit card, or type any information into a computer you do not own. Digital information can be shared easily, with the click of a button.  That is what makes it so convenient. The question of how to ensure that your data is safe is complicated, but a few simple principles are usually worth following.

     There are several sources of "information insecurity" when it comes to our health information. We always think about hackers and identity thieves first. The personal information in your doctor’s computers can be valuable, and there are criminals who would like to have it.  But the more easily data can be appropriately shared, the more easily it can be inappropriately shared.  Information access is inversely related to information security. Anything you type into some computer somewhere, might one day appear on any computer anywhere.  (Unless I can find a reference to that somewhere, I’m going to call it Rubinstein’s Law). 

     The most reasonable course is to practice what I call good "information hygiene". Share only the minimum amount of information necessary, and be sure you know who will have access to it, and for how long.

     DON'T use your social security number for health identification purposes. There is really no reason to write it down, even if there is a line for it on a form. Just leave it blank. Insurance companies are no longer using SSNs for identification purposes. Now they issue their own unique identifying numbers.
     DON'T access your medical information any public Wi-Fi access. Even if you are accessing your information from the doctor's "secure portal". Remember that nothing is "secure" unless your own internet access is secure also. If you're checking the results of your blood tests from a laptop at Starbucks, you might as well post them on your Facebook page.
     DO put expiration dates on your permissions. Many forms that you sign giving access to your data remain in effect unless you specifically cancel them, often in writing. Cross out the part that says "until canceled" and write in an expiration date. I usually pick 1 or 2 years from the day I sign the form. 

    This only scratches the surface. Here is a little more reading on the subject......