The most common reason people lose teeth is periodontal “gum” disease, which is a destruction of the bone and other supporting structures. The most common way to replace teeth today is the use of dental implants. Dental implants replace the roots of the teeth and also rely on the bone as a supporting structure.

Dental implant technology has improved steadily over the past few decades as materials and the understanding of bone integration has advanced. So, when does it make sense to abandon treating a natural tooth and replace it with a dental implant?

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Thanks again to the The Town Common for another great year. At the end of each of the past 11 years, I have used this space to publish these 21 Suggestions for Success authored by H. Jackson Brown, Jr. It is the perfect time to reflect on the year past and prepare for any changes we need to make for the year to come.
How was 2016 for you? While reflecting on the past year is important, thinking forward to the year to come is even more important. The past is in the past.
I thought last year might be the final year for posting this list. However, knowing that readership continues to grow for The Town Common, and realizing how powerful these words can be, I decided to republish. So, cut this out and put it on the refrigerator. Read this list often and take these suggestions to heart. They will be sure to make your 2017 great.

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If you missed Part 1 of this series you can check it out at www.thetowncommon.com. We were talking about what separates the good from the great businesses……no matter what business you are in. This was derived from my recent re-reading of Jim Collin’s classic book “Good To Great: Why some companies make the leap….and others don’t.”

The key currency for any business is not the paper kind; it is intellectual capital. For any business to be successful, intellectual capital must be unleashed. When people are asked how much of their brainpower they actually use, a common response is 20%. The actual percentage is estimated to be much lower. Leaders understand this. They recognize that one of their major challenges is to unleash the latent intellectual capital that already resides within every employee in their organization. In part, this is accomplished by establishing a culture of learning within a business.

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I thought that I would end this year with some stuff that everyone could benefit from. I am honored and humbled to be given this platform each week to bring you information (usually dental in nature). This column and the next may not be “dental” per se, but it is in the sense that it pertains to every business, every employer, and every employee on the planet.

I recently finished re-reading a classic book called “Good to Great: Why some companies make the leap…..and others don’t”, by Jim Collins. No matter what business you are in, whether it is a garage or a dental practice, there are distinct things that separate the average from the great. Number One: a great leader.

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Here is the scenario: You haven’t been to the dentist in a few years. You decide on a dental office and go for a cleaning, x-rays and examination. The dentist hasn’t told you yet, but you have relatively extensive treatment needs. How do you want to hear the news? Do you want the dentist to tell you everything she finds and present a comprehensive treatment plan to get you back to health, regardless of whether you have any kind of dental “insurance” plan? Or, would you rather her tell you the most significant issues that need to be dealt with first, and break the rest of the news to you at a later date?

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Every once in a while someone will say, “There must be a lot less cavities today than there were years ago because of improved home care, fluoride, etc., right?” There are. However, there are still way too many people that present with decay and most of them could use some major improvement in home care and diet.

Yesterday, I went into one of my hygienist’s rooms to check her patient, a 13-year-old boy, and asked the hygienist as I always do how his home care was. She said to me, “Jack, why don’t you tell the doctor how often you told me you brush your teeth.” The boy answered, “About once a week.” ONCE A WEEK?!?! Not to mention the fact that he is in braces too, which makes it even more important to keep the teeth clean.

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Dental hygienists love it when they make suggestions to patients about home care and their dreams are answered when the patient returns 6 months later with noticeable improvement. It might be as simple as adding a good electric toothbrush or waterpik to the patient’s regimen. I would like to say that we are amazed daily by the fruits of our counseling, but that isn’t the case. For whatever reasons there are, changing routines is often difficult.

Nearly 10 years ago I wrote a column aboutan article I saw in a magazine, which is apparently also a book, entitled “Change or Die”. What if you were given that choice? What if the doctor said you had to make tough changes in the way you think and act – or your time would end soon? Could you change? Here are the scientifically studied odds: nine to one. That’s nine to one against you. I don’t think we have made much headway on this over the past 10 years.

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In the last couple of columns I discussed how dental insurance works. If you missed them you can read them at www.thetowncommon.com. In this column, I will discuss the best strategies to get the dental care you need.

I hope the message was clear – you are not missing much if you don’t have dental insurance. Because of the way dental “insurance” is set up, having it is equivalent to a discount on certain items at a store. Just because you don’t have it, doesn’t mean you can’t choose something that fulfills a need or desire. While there may be a few reasons to consider purchasing an “insurance” policy on your own, it usually does not make sense.

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Last week I explained how dental insurance works. This week I will break down the general differences between dental insurances, some things to consider when using your dental insurance, and when it makes sense to consider purchasing insurance if you don’t have it.

I get asked daily by patients who are either self-employed or are not offered insurance through their employer, “Should I consider getting dental insurance?” In most cases, in my opinion, it does not make sense to purchase dental insurance on your own. This goes back to last week’s column as to how dental “insurance” is set up to begin with.

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Most dental offices are bombarded daily with questions about dental insurance. “Do you take my plan? How much is covered? Why is dental insurance coverage so bad?” These are just a few of the questions we hear daily. So, why is dental insurance the way it is?

Dental insurance was first offered back in the early 1970’s. Back then, the first insurance companies offered a yearly maximum benefit level of $1000 per year per patient. In 2016, those insurance companies, and now many others, offer an average yearly benefit of $1000-1500 per year. Yes, you read that correctly; it has not changed much. However, back in the 70’s you could have gotten a lot more dentistry than you can today on that same $1000. Why hasn’t it changed?

There are many answers to this question. The bottom line is that raising the dental insurance limits would be extremely unprofitable for insurance companies. Here are some reasons why.

First is the “use” factor. Many patients who have dental insurance use their insurance right up to that yearly maximum. This is generally not the case with other types of insurance. In fact, the entire dental insurance model is based on a certain percentage of those insured not using their benefits at all. If the yearly benefit was higher, the premiums would need to be much higher for the insurance companies to make a profit. This would destroy the model and there would be many fewer patients signing up for those plans.

The second reason is pre-existing conditions. Many dental problems are often ignored for years and patients will often wait until they have “insurance” to take care of their problems. This is why many insurance companies have a “wait period” for certain dental procedures. When that patient finally has dental coverage and the dentist tells them they need three root canals and three crowns they are shocked to hear that their insurance will only cover a small percentage of the treatment. There is no dental insurance available to cover situations like this because it would be extremely unprofitable for the insurance companies.

Next is the fact that dental problems are much more common than many other health problems. This goes back to my first point of the “use” factor. Look at how expensive medical insurance is. For many people, they may go for routine check-ups to their doctor, but a much lower percentage of patients use their insurance for more costly procedures. However, we all need the health insurance in case of that catastrophic event that would otherwise bankrupt us. For dental insurance companies to remain profitable they have to charge a high enough rate to offset the “people using it” factor, but also a rate low enough for it to be “worth it” for the typical consumer.

And, when you think it couldn’t get any worse, it does. These same insurance companies are cutting reimbursements to dental offices that have participated for years. In addition, there are more and more “discount” plans available which appear more attractive to employers. This continues to brainwash the public that dental insurance is the answer.

Next week I will expand on this with a discussion of the difference between the different kinds of dental insurance available: those you can go to whomever you want and those where you have to pick a dentist from a list. The final column of this series will give you suggestions for getting the dental health you need regardless of insurance.