I’m very proud to be here with Kendalyn Lutz-Craver from Cornerstone Dentistry in Shelby, NC. There’s a huge need in the community for proper senior dental care. There’s a hole in the Medicare/Medicaid system to pay for proper dental care for seniors, and many times seniors will either put off care or not receive proper care when they actually need it. There’s proof of a connection between longevity and dental care. So it’s an issue that’s germane to seniors and is certainly something that needs to be addressed. Therefore, Kendalyn and I have been talking, trying to figure out how to work on some of these issues and have given it a fair amount of discussion and thought. I wanted to bring those thoughts of mine and of Kendalyn’s to you.
Cornerstone Dental Associates is a pretty amazing facility.
Thank you, we’re very proud of it. We’ve been in there 6 years now, and it’s the first green building in the county. We were really thoughtful about the process and wanted to take something that’s not fun for anyone – dentistry – and make it a more comfortable environment, an environment where you’re excited to come get care and you feel like you’re a part of the family.
It’s the first green building in the county?
Yes, a few patients did ask me if we were going to actually paint the building green. But this means that it is LEED certified, LEED referring to Leadership in Energy and Environmental Design, and so it’s a point system. You work with the architect, you work with the contractor and you achieve different points to get your certification. We recycled about 75% of our construction waste. Every employee is guarantee a daylight view. We do things that reduce the chemicals that come off the paints and furniture. The fresh air comes in, so that exchange is permitted. You just do a series of things to make it a positive work environment, and a lot of research has shown that with green buildings, you produce healthier employees as well. There are less sick days.
What made you want to be a dentist?
I was part of that small percentage of people that always loved going to the dentist; it was always fun for me, I had a great dentist growing up. Teeth are very important. If you ask people what they notice when they first meet people, eyes and teeth seem to be the two that come up. And it changes the demeanor of someone if they don’t have confidence in their teeth. You see it tremendously. As for my journey, I grew older and figured out what I liked in school. I loved math, I loved science and then thought about what my goals were into adulthood and that I loved the idea of having a career where I could be my own boss. And I could use the math and science that I like, but also have some flexibility of schedule. It was important to me to have a work-life balance, to be able to be a mom as well as a dentist.
What do you do when you see a senior?
We start every patient with what we call an initial exam, and it’s a long appointment. You’re going to hang out with me and my assistant for an hour and a half. We’re going to take any needed X-rays and photos, and we’re just going to talk about the goals you have and figure out the needs you have, the best way to tackle them, and how to make them affordable for you. A lot of patients are surprised when they call our offices because they think, “Well I just need to come in and get a cleaning.” But what people don’t realize is there are different types of cleanings based on your needs and it’s crazy to jump in before we know what’s going on. I love that chance to get to know the patient and for the patient to start to get to know me, to build a good relationship with me. I want patients that are comfortable asking questions any time. So we start there.
Sadly, dental insurance is not like health insurance, so more than anything we think of it as a benefit. And in this day in time, it’s a benefit some people get with employment. I don’t know if there’s any anymore that get dental benefits after they retire. So we offer lots of payment plans, lots of ways to make it affordable, and we try to work with our patients once they hit the age of about 50-55, until 65 or whenever the retirement horizon is to get their mouth ready for retirement, ready for the time when hopefully they just need maintenance. It’s very much like pre-planning.
For instance, if you had big fillings and we need to transition them to crowns, we’re looking at what we have to do over the next five to ten years. Doing it all at once would be overwhelming and extremely expensive, so we break it down; we do a little bit at a time to step patients along. Many seniors are on a fixed income, so the biggest message to get out to patients first and foremost is, just because you don’t have dental insurance doesn’t mean that dentistry is not available, that it’s so far out of reach that sometimes we have a tendency to equate dental costs with health costs. Dentistry doesn’t have the same cost as one would have with health care; it is an investment. It’s not cheap by any means but it is not prohibited if you do not have dental insurance.
So it’s a misconception to think if you don’t have dental insurance, you can’t afford dental work?
Yes. We figure out first everything you need. If you only need two hygiene visits a year with diagnostic X-rays, we have some patients that pay that and divide it up into twelve payments. They make a payment every month if they want a small payment. Others choose to pre-pay before their visit, if you pre-pay you get a 5% discount. Some divide it every three months. There’s lots of different ways to do it.
What about longevity? I’ve always wondered if there’s a connection between longevity and dental care, and I understand that there is. Is that right?
There definitely is. 20 is our magic number. At the office, we do a party every year to celebrate all of our patients, 80 years or older, with 20 or more of their natural teeth. But all the research shows that 20 teeth have to function together. So 10 top and 10 bottom lined up. If you have 20 or more, you’re going to function well, it’s going to improve longevity; less than 20, we see an increase in mortality rate. So as you begin to lose teeth and pass that tipping point, your life expectancy decreases. That’s big. Keep as many of your natural teeth as you can.
What about gum care?
Gum care is huge, and a lot of people are becoming more familiar with that, but periodontal disease – this is an inflammatory process, it’s caused by bacteria. That leads to chronic inflammation, bacterial issues, Diabetes, and cardiovascular disease. Some studies now are looking at dementia. It’s all linked. But it makes sense, and if we stop and think about it, sometimes we think about our mouth as a completely different part of our body. It’s not; it’s where everything starts. And so it has a huge systemic impact, and that comes into hygiene care. It is so important to keep your gums healthy.
The other thing we like to work with patients: I’m a huge proponent of electric toothbrushes, but especially as we get older because if you think about a small toothbrush, you need good dexterity and you need a good grip for a small, narrow toothbrush. But a nice big toothbrush, we love Sonicare, it does better than anything we can do. I love to get patients with an electric toothbrush. We also have patients who are on medications, and what’s a side effect of those medications? Dry mouth. Dry mouth leads to increased cavities, and it all cycles. So when you come, throw in a fluoride treatment with your hygiene visit and then do fluoride rinses at home. We also like to look at diet. Sadly, we’re a country of a lot of diabetics and obese people; a lot of that comes from poor diet choices such as soft drinks, sports drinks – sugar or sugar free, because a lot of that is the acidic component. Once you get dry mouth, you want to keep your mouth wet so we start grabbing candies to suck on. So it’s thinking about all those things. If you’re going to keep them, you’ve got to get smart about it.
Everything has to do with longevity. Once you begin to lose teeth, you start to chew with less efficiency. And when it comes to dentures, you’re affected there as well. Not only do the bones shrink, but your jaw muscles begin to atrophy because you can’t apply near the biting force onto a denture that you can with your natural teeth. So for anyone with dentures who wants to chew a good steak, they have to chew seven times more than someone without dentures because of the decreased force. All that adds up. You don’t have as many teeth, it’s hard for you to chew, and what do you do? You start eating more processed foods, and everything just devolves. That’s a lot of the increased mortality, losing teeth.
If you think about the history of dentists in this country, you realize it’s crucial. If you let a toothache go on long enough, that can be a heart issue and an infection. Dental care is extremely important to longevity and health.
Call me if you have any questions:
Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street, Shelby