Dr. Ames is currently focusing on the promotion of Biomimetic Dentistry to Patients and Dentists.
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Dr. Ames is currently focusing on the promotion of Biomimetic Dentistry to Patients and Dentists.
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A High Level Overview Of Central Concepts
Dr. Margaret Ames practices Biomimetic Dentistry in Huntington, NY.
She is the Founding President of The Academy of Biomimetic Dentistry."Biomimetic Dentistry values the life of tooth structure over the life of the restoration. What that means is that the vitality of the tooth is more important than the life of the restoration. These restorations are Minimally Invasive, Conservative restorations that protect the pulp and keep teeth vital. And should they fail... they fail safely in such a way that it's the restoration that fails and not the tooth."
"Teeth treated Biomimetically are restored in a way that mimics natural oral anatomy."
"Amalgams are a rigid, aggressively placed filling material which require the removal of healthy tooth structure just so they stay in place."Both of these techniques lead to more extensive, and expensive, future treatments. Such treatment models... (where the 'State of the Art' in dental care results in cascading failure)... are flawed models."(See Mechanical retention.)
Amalgams expand, leak and over time, cause teeth to crack.
Conventional Composite-Resin (white fillings) shrink over time due to polymerization. They stress tooth anatomy, create paths for microleakage and enable recurrent decay."
"Biomimetic Restorations are successful in both anterior and posterior dentition. Case reviews over a 10-15 year period suggest a projected service life of 30 years or longer... far exceeding the expected service life of both amalgams and conventional composite-resin."
"Biomimetic Restorations mimic the natural rigid and flexible portions of the teeth with advanced adhesive bonding techniques, with a bond SO EXACT that the distance between the restoration and the existing healthy tooth structure is too small for even a single bacterium to get through. This virtually eliminates recurrent decay."See this article.
"Biomimetic Dentistry is becoming the sought-after treatment of choice among informed patients. It can Reduce Costs, Improve Health and Increase Access To Care."The content below addresses important economic aspects.
Citations...
- "No tooth deserves a crown. The age of adhesive rebuilding is here and now. The science is clear and succinct. Adhesive treatment is analytically based and predictable."
- Journal of the Arizona Dental Association, Oct 2009
- "Dental amalgam relies on mechanical interlocking for adhesion and the destruction of sound tooth structure is necessary with re-intervention in one in three cases being extraction or crowning."
- Dr. Garry Fleming Trinity College, Dublin, Ireland
- "Every time a dentist drills into a tooth, you're condemning that person to a refilling years down the road."
- Dr. James Bader. UNC School of Dentistry. NY Times: November 28, 2011
- "For young patients we treat up to their 18th birthday who continue seeing biomimetic practitioners, they have an almost zero risk of needing advanced, invasive treatments for the rest of their lives. This speaks to root canals, crowns and other catastrophic treatment. This is not speculation. This is what has been seen."
- Tim Rainey DDS
- "When [a tooth with] an amalgam fails, almost always you have a much larger problem than you started with."
- David Alleman DDS
- "Wall-To-Wall Silver [amalgam] fillings in adults demonstrate how teeth have been mutilated in the name of dental care."
- Michel Haynie DDS
- "The failure of the restoration should always precede the failure of the tooth."
- Margaret Ames DMD
Context...
It's a misnomer to call today's Dentistry "Restorative Dentistry". It alleviates pain & infection. It attempts to restore most function. But it does not actually restore the tooth. It merely delays, then exacerbates a condition, and contributes to the Dental Cycle of Failure (image1 image2) we accept, live with and continue to pay for.Assertions...
- In 2013, the US economy spent about $111,000,000,000 on dental services. (2013 CMS Report available here. 2014 CMS Report available here.)
- The U.S. population in 2012 (the last year for which we have granular data) was about 314,000,000 people.
- Dentists who perform Biomimetic Dentistry report an average reduction in root canal therapy by 75% and this leads to an equal reduction in crowns, bridges, dentures and implants in their practices.
- Biomimetic Dentistry could save the economy approximately 68% in oral health costs.
(See a video for details on how this 68% savings number was derived.)Background...
Approximately 80% of the procedures in any given dental practice are performed on previously treated teeth.
Roughly 75% of the fillings placed each year are done with materials and techniques developed and published by G.V. Black in 1896. Restated... roughly ¾ of today's dental procedures were defined almost 120 years ago and are still taught in dental schools today. (Dental amalgam and "Extension For Prevention" cavity prep techniques.)
The balance are typically composite-resin restorations (white fillings) which stress tooth structure.
Both modalities enable and encourage Microleakage, Recurrent Decay and future failures.Dental office profit centers typically revolve around root canals, crowns, bridges and dentures: An indicator of the poor outcomes conventional dentistry provides.
A 2013 study by the PEW Trusts estimated the lifetime costs for just one molar at around $6,105.
The Centers For Medicare and Medicaid Services (CMS) published data saying that in the United States in 2013, the cost to the economy for dental services was on the order of $111 Billion. Costs were allocated as:
Out of Pocket 42% $46.5 Billion Medicaid 11% $12.2 Billion Dental Plans 47% $52.1 Billion
Dental Economics: A Long Island View...
Note: The data in the below tables are based on per-capita calculations of 2013 national oral health costs. * CMS- Centers For Medicare And Medicaid Services.
Nassau County Estimated Population: 1,349,233 CMS U.S. 2013 Percentages 42% 11% 47% Total Estimated Dental Expenditures Out-Of-Pocket Medicaid Private Insurance Current Total Costs: 100% $476,562,293 $200,156,163 $52,421,852 $223,984,278 Projected Savings: 68% ($324,062,359) ($136,106,191) ($35,646,860) ($152,309,309) Projected Costs: 32% $152,499,934 $64,049,972 $16,774,993 $71,674,969 Suffolk County Estimated Population: 1,499,273 CMS U.S. 2013 Percentages 42% 11% 47% Total Estimated Dental Expenditures Out-Of-Pocket Medicaid Private Insurance Current Total Costs: 100% $529,557,889 $222,414,313 $58,251,368 $248,892,208 Projected Savings: 68% ($360,099,364) ($151,241,733) ($39,610,930) ($169,246,701) Projected Costs: 32% $169,458,524 $71,172,580 $18,640,438 $79,645,507 All Long Island Estimated Population: 2,848,506 CMS U.S. 2013 Percentages 42% 11% 47% Total Estimated Dental Expenditures Out-Of-Pocket Medicaid Private Insurance Current Total Costs: 100% $1,006,120,182 $422,570,476 $110,673,220 $472,876,486 Projected Savings: 68% ($684,161,723) ($287,347,924) ($75,257,790) ($321,556,010) Projected Costs: 32% $321,958,458 $135,222,552 $35,415,431 $151,320,476
Calculations Based On 2012 Population Estimates and CMS 2013 Data.
The above numbers are not cut in stone. They are mathematical calculations which point to a greater truth.
An actuarial analysis would clarify and give better definition to the savings and overall health benefits that would be available.
However, in a relatively short period period of time, we could improve and expand oral health care and even generate savings in the process.
Policy Considerations...
Consumer Out-Of-Pocket Savings:Medicaid:
- $287M stays in the pockets of consumers. This is a modest $101.00 per capita but not something to be dismissed.
Dental Insurance (Dental Plans):
- If $75M savings were available, there might be no need to invest in the dental infrastructure for additional Community Health Centers (FQHCs). Rather, raising reimbursements for individual procedures would enable the existing practitioners and infrastucture to accomodate the needs of those currently lacking access.
- Savings in Medicaid could be a model for programs such as IHS (Indian Health Services), Medicare, Military* and Veterans programs, in conjunction with those programs' existing funding resources.
- $321M savings would only occur after several years of funding moderate additional reimbursements to practitioners for Biomimetic procedures. After that, these windfalls could be used to subsidize future premium reductions and expanded coverage as well as increase access to care for those lacking.
* Defense department officials have called oral health "essential to readiness" of our military forces. The Army reports that more than 1 in 5 National Guard and Reserve soldiers required dental treatments before they could be deployed overseas for Operation Desert Storm. And a 2008 report revealed that 52% of new military recruits had dental problems that delayed their deployment overseas. https://www.cdhp.org/state-of-dental-health/schoolandbeyond
Thoughts...
Minimally Invasive Adhesive Biomimetic Dentistry could reduce these costs by as much as 68% and virtually eliminate the need for children to go through the treatments their parents endured and the outcomes they now live with.
Reduced costs could:This without additional spending but rather, with savings.
- Lower Dental Plan Premiums
- Trim Government Healthcare Spending
- Expand Dental Coverage
- Increase Access To Care For Those Lacking Such Access In Both The Public and Private Sectors.
This benefits our citizens, our children, business and the economy. Not to mention... Lost time from work and school as well as costly Emergency Room visits for Non-Traumatic Dental pain. In an incalculable way, it also speaks to the link between oral health and systemic health.
The only way dentistry will change is by patients asking for better alternatives.
For an economic view of other states and counties, please follow this link.
...courtesy FindABiomimeticDentist.com
"Sometimes your joy is the source of your smile and sometimes your smile is the source of your joy."