• Dentistry,  Medicaid

    State of Texas Encouraging Teens to Get Pregnant for Orthodontic Braces?

    February 6, 2012 /

    This is definitely government run amok in Medicaid and in the state of Texas.

    No one would say being a single mom is easy. Especially being a single, teenage mother.

    But the State of Texas appears to be encouraging teenage girls to become pregnant so they can receive free dental care under Medicaid.

    Watch the excellent investigative video above and explain to me why the State of Texas is even covering orthodontics with federal medicaid dollars when California has NO dental medicaid for adults – at all?

  • Dentistry,  Medicaid

    Crooked Teeth Video: The Investigative Story of the Texas Orthodontic Medicaid FLAP

    February 6, 2012 /

    This is an excellent investigative series, albeit long video that discusses the problems with the State of Texas and their delivery of orthodontic care via Medicaid.

    The WFAA-TV news special “Crooked Teeth” highlights an 11-part investigative series that reveals tens of millions of dollars in questionable billings and a troubling lack of oversight of the Texas Medicaid orthodontic program.

    Although Texas Medicaid limits orthodontic care to poor children with severely misaligned teeth, “Crooked Teeth” reveals Texas paid more for Medicaid-funded dental orthodontics than the other 49 states combined.

    In fact, a number of Texas dental clinics receive more in Medicaid orthodontic reimbursements than the amounts paid annually to entire states like Illinois, Georgia, Florida and California.

    The half-hour news special “Crooked Teeth” raises questions about other Medicaid reimbursements nationally, including a troubling payment policy by one of the nation’s largest government contractors.

    Watch it all and wonder why government financed and run health care is just filled with danger – fraud and cronyism included.

  • Pinboard Links,  The Afternoon Flap

    The Afternoon Flap: December 6, 2011

    December 6, 2011 /

    These are my links for December 1st through December 6th:

    • Senate Republican filibuster blocks Obama D.C. Circuit nominee Caitlin Halligan – Tuesday’s vote is notable in that it marks the second time that Senate Republicans have blocked an Obama judicial nominee. In May, Republicans filibustered Obama’s nomination of Goodwin Liu to the U.S. Court of Appeals for the 9th Circuit following a protracted battle over what GOP senators cited as the University of California at Berkeley law professor’s liberal views.

      Six years ago, a bipartisan “Gang of 14” senators negotiated an agreement aimed at preventing filibusters of judicial nominees except under what they termed “extraordinary circumstances.” On Tuesday, as in May’s vote on Liu, the four Republican members of that group who remain in the Senate – Sens. John McCain (Ariz.), Lindsey Graham (S.C.), Susan Collins (Maine) and Olympia Snowe (Maine) – voted “no,” a sign that Republicans as well as Democrats have now come to view filibusters of judicial nominations as fair game.

    • Glenn Beck the latest GOPer to take on Gingrich – Conservative radio host Glenn Beck became the latest Republican to go after newly minted presidential frontrunner Newt Gingrich Tuesday.

      After saying the radio segment would not be a “gotcha interview,” Beck aggressively questioned the former House speaker over issues including climate change and health care reform.

      Gingrich somewhat famously recorded a public service announcement in 2008 with then-House Speaker Nancy Pelosi about steps to combat climate change, something Beck in the interview called “the dumbest moment.” In response, Gingrich toed the line on the issue, saying he believed “in the environment in general,” and that evidence exists on both sides of the climate change argument.

      “I never believed in Al Gore’s fantasies,” Gingrich said, before adding that he worked against cap and trade legislation as a member of Congress.

      Criticism of his long record in public office has increased with his recent rise in polling of Republican voters, something Beck perpetuated during his questioning over Gingrich’s stance on health care, and more specifically the changes to Medicare he would or would not support.

      Gingrich said he promotes a practical approach to changing the program, instead of completely overhauling or dismantling it, as some, including House Budget Committee Chairman Rep. Paul Ryan and Beck have suggested.

      “I think what you want to have is a system where people voluntarily migrate to better outcomes, better solutions, better options, not one where you suddenly impose upon,” Gingrich said. “I’m against ‘ObamaCare,’ which is imposing radical change and I would be against a conservative imposing radical change.”

    • Heartbreak Awaits Republicans Who Love Gingrich – Before Republicans put Newt Gingrich at the top of their party, they should consider what happened the last time he led it.
      In the mid-1990s, Gingrich was the de facto head of the Republican Party. He helped lead it to victory in the congressional elections of 1994, which brought about real accomplishments such as welfare reform. But once he attained power, both his popularity and that of his party started to plummet. In the aftermath of his leadership, a Republican was able to take the presidency only by pointedly distancing himself from Gingrich.
      Conservatives who dislike George W. Bush’s compassionate conservatism have Gingrich to thank for it. After Gingrich lost the budget battles with President Bill Clinton, it took 15 years for any politician to take up the cause of limited-government conservatism that he had discredited.
      Although Gingrich isn’t solely responsible for the Republican policy defeats of those years, his erratic behavior, lack of discipline and self-absorption had a lot to do with them. He explained that one reason the federal government shut down in 1995 was that he was angry that Clinton had snubbed him during an international flight. The Clinton White House then released pictures of the two men gabbing on the plane. Later negotiations didn’t go well, with Gingrich saying, “I melt when I’m around him.”
    • Poll Shows Age Gap in G.O.P. on Immigration – With immigration now a front-burner issue in the Republican presidential contest, a new poll shows a substantial age gap among Republican voters over whether there should be a path to citizenship for immigrants who are in the country illegally.

      A majority – 57 percent — of Republicans who are 65 and older say that tighter border security and tough law enforcement should be the only focus of immigration policy, with no path to citizenship for illegal immigrants, according to a poll released Tuesday by the Pew Research Center for the People and the Press, a nonpartisan group in Washington. Only about one-quarter of this group, or 24 percent, favor combining strict enforcement with a path to citizenship for illegal immigrants.

      Among Republicans who are younger than 30, the poll found, 42 percent favor a combined approach of tough enforcement against illegal immigration with a path to citizenship, while 30 percent wanted only enforcement. Among these younger Republicans, another 26 percent said that opening a path to citizenship should be the immigration priority, with or without tougher enforcement.

      The poll showed other differences. Among Republican voters who agreed with the Tea Party, 52 percent favored a policy based only on tougher enforcement. Among Republicans who disagreed with the Tea Party or had no opinion, 36 percent wanted only enforcement, while 44 percent favored policies pairing enforcement with a path to citizenship.

    • (500) http://flapsblog.com/2011/12/06/president-2012-gop-poll-watch-gingrich-37-vs-romney-22-vs-paul-8-vs-perry-7/ – President 2012 GOP Poll Watch: Gingrich 37% Vs. Romney 22% Vs. Paul 8% Vs. Perry 7% #tcot #catcot
    • Bachmann: Newt Gingrich is a frugal socialist – Responding to Newt’s justification of his support of the Prescription Drug entitlement that was passed under the Bush administration, Bachmann said:

      It doesn’t help to have a frugal socialist. That’s really what we’re talking about is managing socialism and trying to be a frugal socialist.

      Beck, recognizing that a headline had just been made sought to clarify, asking Bachmann “Did you just say that Newt Gingrich is a socialist?” Bachmann responded:

      What I’m saying is that – I’m saying a frugal socialist, yes! Because you’re looking at proposals and programs that are in effect redistribution of wealth and socialism-based, and are we going to have real change in the country or are we going to have frugal socialists?

    • Why Newt Gingrich is an easy target—John Podhoretz – One of the pithiest quotes in American history may also be the dumbest: “There are no second acts in American lives.”

      F. Scott Fitzgerald said it and promptly died before he could have a second act — but he would have had one, because that’s what tends to happen to famous and accomplished people in the United States. It’s happening to Newt Gingrich right now.

      For those of us who live and breathe politics and make our livings in and around it, the words “Newt Gingrich” mean something entirely different than they do to the Republican primary voters who are now shifting over to him in droves.

    • President 2012 GOP Iowa Poll Watch: Gingrich Leading in Yet Another Poll | Flap’s Blog – FullosseousFlap’s Dental Blog – RE: Good question. But, Gingrich’s baggage has been around for a long time.
    • Dilbert December 4, 2011 – Carpool Poser » Flap’s California Blog – Dilbert December 4, 2011 – Carpool Poser
    • President 2012 GOP Iowa Poll Watch: Gingrich Leading in Yet Another Poll | Flap’s Blog – FullosseousFlap’s Dental Blog – President 2012 GOP Iowa Poll Watch: Gingrich Leading in Yet Another Poll #tcot #catcot
    • Osteoporosis drugs helped astronauts, scientists say – Researchers have confirmed that five astronauts who stayed long term at the International Space Station were able to prevent bone-density loss by taking osteoporosis drugs.

      Astronauts in a weightless environment usually lose 5 to 7 percent of their bone density in six months even while exercising two hours a day. In the study conducted by researchers of the Japan Aerospace Exploration Agency, Tokushima University and others, five astronauts who stayed in space for up to 163 days exercised daily and took bisphosphonates used to treat osteoporosis once a week during their stay on the space station. As a result, researchers found almost no bone-density loss in the astronauts.

    • Flap’s Dentistry Blog: The Morning Drill: December 6, 2011 – The Morning Drill: December 6, 2011
    • Day By Day December 6, 2011 – Proud | Flap’s Blog – FullosseousFlap’s Dental Blog – Day By Day December 6, 2011 – Proud #tcot #catcot
    • @Flap Twitter Updates for 2011-12-06 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-12-06 #tcot #catcot
    • foursquare :: Gregory Flap @ Starbucks – On the way home from Vegas (@ Starbucks)
    • foursquare :: Gregory Flap @ Cancun Resort – Soon will leave Las Vegas to return home in Thousand Oaks (@ Cancun Resort)
    • foursquare :: Cancun Resort :: Las Vegas, NV – I just ousted Ryry as the mayor of Cancun Resort on @foursquare!
    • @Flap Twitter Updates for 2011-12-05 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-12-05 #tcot #catcot
    • foursquare :: Gregory Flap @ Cancun Resort – Up, Starbucks completed & ready for Las Vegas Half Marathon. #rnrlv #stripatnight (@ Cancun Resort)
    • First Read – Gingrich takes control in Iowa – RT @ZekeJMiller: NBC Marist poll in NH: Romney 29, Gingrch 23, Paul 16, Huntsman 9.
    • @Flap Twitter Updates for 2011-12-04 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-12-04 #tcot #catcot
    • The Cain Solutions – RT @katieharbath: now up
    • The Cain Solutions – RT @katieharbath: now up
    • (500) http://www.hermancain.com/livestream – RT @THEHermanCain Team HC: Livestream coverage of Mr. Cain’s announcement begins at 1:00 pm ET. #tcot
    • Barbour Says Perry Still Has a Chance – Barbour Says Perry Still Has a Chance
    • Romney and Gingrich, from bad to worse – Republicans are more conservative than at any time since their 1980 dismay about another floundering president. They are more ideologically homogenous than ever in 156 years of competing for the presidency. They anticipated choosing between Mitt Romney, a conservative of convenience, and a conviction politician to his right. The choice, however, could be between Romney and the least conservative candidate, Newt Gingrich.

      Romney’s main objection to contemporary Washington seems to be that he is not administering it. God has 10 commandments, Woodrow Wilson had 14 points, Heinz had 57 varieties, but Romney’s economic platform has 59 planks — 56 more than necessary if you have low taxes, free trade and fewer regulatory burdens. Still, his conservatism-as-managerialism would be a marked improvement upon today’s bewildered liberalism.

    • Barbour Says Perry Still Has a Chance – Mississippi Gov. Haley Barbour (R) tells the New York Times that it’s not clear Mitt Romney will be the Republican presidential nominee.

      Said Barbour: “I don’t think it’s clear. I think people make the mistake of writing off Rick Perry and believe he can’t come back. He’s got a mountain to get over, but I don’t think it’s impossible. Both Newt and Romney have a lot of support, but I don’t think it’s a two-man race. I think Perry could get back in it with Gingrich and Romney. I can’t look you in the eye and say nobody else can come up. You’ve got to learn your lesson this year not to say that about anybody.”

      He added: “I haven’t decided who is the best nominee for the party. I can see how either one of them could be the best nominee. But I think it is premature to write off Perry. He is a very successful governor. This is very unpredictable. I’ve never seen a nomination on our side like this.”

    • Mitt Romney looks to outlast and outwork Gingrich to GOP nomination – The Romney campaign believes organization will be particularly critical because of changes in the nominating process. In the past, the winner of a state — or, in some cases, the top vote-getter in each congressional district — won all the delegates. But in 2012, most of the 30 states that hold contests before April 1 will award delegates proportionally. The ones that will come after will still be winner-takes-all.

      That means a candidate could lose a number of states but still remain competitive in the race to gain the majority of the 2,427 delegates at stake.

      As a reminder to take the long view, Romney’s political director, Rich Beeson, walks around headquarters carrying a matrix in his pocket charting which states award delegates proportionally and which are winner-takes-all.

      “We’re not Kentucky Fried Chicken,” Beeson said. “We don’t have the luxury to just do one thing and do it right.”

    • Day By Day December 3, 2011 – Weaning | Flap’s Blog – FullosseousFlap’s Dental Blog – Day By Day December 3, 2011 – Weaning #tcot #catcot
    • foursquare :: Gregory Flap @ Cancun Resort – Drinking Starbucks with Alice listening to the Las Vegas wind. (@ Cancun Resort)
    • @Flap Twitter Updates for 2011-12-03 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-12-03 #tcot #catcot
    • yfrog Photo : http://yfrog.com/ntl8kej Shared by Flap – At Las Vegas Rock and Roll Expo
    • foursquare :: Gregory Flap @ Sands Convention Center – Rock and Roll Expo is very big and full of runners #rnrlv (@ Sands Convention Center w/ 21 others)
    • foursquare :: Gregory Flap @ Sands Expo Convention Center Hall B – At the Rock and Roll Expo #rnrlv (@ Sands Expo Convention Center Hall B)
    • foursquare :: Gregory Flap’s Badges :: Overshare – I just unlocked the “Overshare” badge on @foursquare!
    • foursquare :: Gregory Flap @ The Palazzo Resort Hotel & Casino – Almost at the Rock and Roll Expo #rnrlv (@ The Palazzo Resort Hotel & Casino w/ 5 others)
    • foursquare :: Gregory Flap @ Mandalay Bay Casino – Where the half marathon will start on Sunday night #rnrlv (@ Mandalay Bay Casino)
    • foursquare :: Gregory Flap @ M Resort Spa Casino – We have arrived in Vegas. Heading to Rock n Roll Expo #rnrlv (@ M Resort Spa Casino w/ 2 others)
    • foursquare :: Gregory Flap @ I See Vegas!! – I see it (@ I See Vegas!!)
    • foursquare :: Gregory Flap @ Almost Vegas Baby! – Almost…. (@ Almost Vegas Baby!)
    • foursquare :: Gregory Flap’s Badges :: Mall Rat – I just unlocked the “Mall Rat” badge on @foursquare! Time for a fancy pretzel.
    • foursquare :: Gregory Flap @ Primm Fashion Outlet – On our way to Las Vegas Rock n Roll Expo #rnrlv (@ Primm Fashion Outlet)
    • foursquare :: Gregory Flap @ Baker, CA – Civilization? (@ Baker, CA)
    • foursquare :: Gregory Flap @ Zzyzzx, Solve For Z – On the road to Vegas (@ Zzyzzx, Solve For Z)
    • foursquare :: Gregory Flap @ Starbucks – On the way to Vegas with Tara and Alice (@ Starbucks)
    • President 2012: The Question – Mitt or Newt? | Flap’s Blog – FullosseousFlap’s Dental Blog – President 2012: The Question – Mitt or Newt? #tcot #catcot
    • U.S. Unemployment Rate Falls to 8.6 % From 9% – But…. | Flap’s Blog – FullosseousFlap’s Dental Blog – U.S. Unemployment Rate Falls to 8.6 % From 9% – But…. #tcot #catcot
    • @Flap Twitter Updates for 2011-12-02 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-12-02 #tcot #catcot
    • Unauthorized Immigrants: Length of Residency, Patterns of Parenthood – Nearly two-thirds of the 10.2 million unauthorized adult immigrants in the United States have lived in this country for at least 10 years and nearly half are parents of minor children, according to new estimates by the Pew Hispanic Center, a project of the Pew Research Center.

      These estimates are based on data from the U.S. Census Bureau’s March 2010 Current Population Survey, augmented with the Center’s analysis of the demographic characteristics of the unauthorized immigrant population using a “residual estimation methodology”1 that the Center has employed for many years.

    • Leno Ad
      – YouTube       – I like this ad from Rick Perry Can Perry make a come back, if Newt heads downward in the polls?
  • Pinboard Links,  The Morning Flap

    The Morning Flap: November 21, 2011

    November 21, 2011 /

    These are my links for November 18th through November 21st:

    • Parties brace for ‘super’ fallout – Now, both parties are quickly trying to figure out how to turn the committee’s embarrassing failure into a political win for their side.

      The Democratic message: We stood up to Republicans looking to gut Social Security, slash Medicare and permanently extend the Bush-era tax cuts for high income Americans.

      The Republican counterattack: Democrats wanted little more than tax increases and refused to consider changes to deficit-driving health care entitlements. Both sides are positioning themselves as the party that compromised and sought a middle-ground.

      But will this political posturing work for a Congress that had a 9 percent approval rating in one recent poll? Or will it just back fire with voters? Many lawmakers are worried about what the supercommittee has wrought for both sides.

    • Lawmakers already taking aim at auto-cuts – Failure by Congress’ debt-cutting supercommittee to recommend $1.2 trillion in savings by Wednesday is supposed to automatically trigger spending cuts in the same amount to accomplish that job.
      But the same legislators who concocted that budgetary booby trap just four months ago could end up spending the 2012 election year and beyond battling over defusing it.

      Sens. John McCain, R-Ariz., and Lindsey Graham, R-S.C., say they are writing legislation to prevent what they say would be devastating cuts to the military. House Republicans are exploring a similar move. Democrats maintain they won’t let domestic programs be the sole source of savings.

    • Deficit Deal Fell Apart After Seeming Agreement – Called away from dinner tables, the Jets-Patriots game on television and, in one case, a soccer team party, several Democratic members of the special Congressional committee on deficit reduction raced to the office of Senator Patty Murray for a hasty 8:30 meeting to discuss the outlines of a potential agreement. Crucially, it appeared to have the backing of at least one Republican on the 12-member panel even though it included a tax increase.

      As the members spoke, they began to see the outlines of a deal, tentatively agreeing on tax rates, revenues, spending cuts and changes to Social Security and Medicare, according to interviews with members of the committee and their aides.

    • Supercommittee blame everywhere – A full-scale blame game erupted into public view Sunday after nearly three months of secretive negotiations on the supercommittee that failed to resolve an impasse to cut at least $1.2 trillion in deficits over the next decade.

      Fanning out across the Sunday talk shows just hours before the supercommittee’s deadline, Republicans insisted that Democrats wanted to institute a $1 trillion tax hike, while Democrats argued that the GOP wanted to gut popular entitlements and protect the rich. And both sides insisted they were willing to compromise when the other refused to move off their partisan positions.

    • Where in the world is Obama? – The president was in Hawaii while the supercommittee hit stall speed. What is new about this? Very little.

      Throughout his term, President Obama has avoided leading on the issue of fiscal responsibility. He walked away from his own commission, the one led by former Sen. Alan Simpson (R-Wyo.) and former White House Chief of Staff Erskine Bowles, when he found its report filled with inconvenient choices.

      Now in a week when leadership is needed to push this critical committee to do something big and bring the nation’s fiscal house back into order, the president once again disappears. It causes one to wonder, why?

    • Obama has work cut out for him in order to win Michigan in 2012 – President Barack Obama says he saved Michigan’s auto industry, but that isn’t helping his 2012 re-election bid in Macomb and Oakland counties, where Republican front-runner Mitt Romney’s strength helps give him a 5-point lead in the state a year before the election, a Free Press poll shows.

      There’s time for the president to woo voters, but without the two key suburban Detroit counties, it would be difficult for Obama to win Michigan, a state whose voters have backed Democratic candidates in the last five presidential elections.

      In a head-to-head matchup statewide, Romney tops Obama 46%-41% in the poll.

      In Macomb, where Obama received 53% of the vote in 2008, the president trails Romney, 68%-20%. Even controlling for a high margin of error because of a small sample size in the county, Obama trails Romney in Macomb by at least 20 percentage points.

    • Methamphetamine Use Linked to Schizophrenia – Heavy methamphetamine use may be associated with an increased risk for schizophrenia, new research suggests.

      A large cohort study of California inpatients without a history of psychiatric disorders found that those with methamphetamine-related conditions were 9 times more likely to have a subsequent schizophrenia diagnosis than non–drug users, and an almost 1.5- to 3-fold diagnosis risk compared with heavy users of cocaine and opioids, but not cannabis.

      “This provides the first world-wide evidence for a long-standing debate that suggests that methamphetamines may facilitate the development of schizophrenia in a small subset of users,” lead author Russell C. Callaghan, PhD, research scientist at the Center for Addiction and Mental Health (CAMH) in Toronto, Canada, told Medscape Medical News.

      “Methamphetamine users often present to clinical and emergency department settings with psychosis. And our findings suggest that these people need to be monitored closely for an attenuation of their psychotic symptoms. Also, given the side effects with antipsychotic medications, I think we really need to prescribe those treatments judiciously,” said Dr. Callaghan.

      He added that the study findings do not apply to patients who take lower and controlled doses of amphetamines for medical purposes, such as for attention-deficit/hyperactivity disorder.

    • How I ended up leaving Poynter JIMROMENESKO.COM – “How did this go off the rails?” Poynter’s attorney asked me during a Nov. 12 phone conversation about my threat to file a cease and desist order against the institute for using my name on their website after being taken off the payroll.

      Read it all

    • @Flap Twitter Updates for 2011-11-20 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-11-20 #tcot #catcot
    • Capitol Alert: Think Long coalition to propose California tax overhaul – California Think Long Tax Increase = Think STUPID and will fail at polls. Think Long = bipartisan #FAIL
    • Rep. Elton Gallegly: Our Friends in Israel Deserve Better | Flap’s Blog – FullosseousFlap’s Dental Blog – Rep. Elton Gallegly: Our Friends in Israel Deserve Better #tcot #catcot
    • foursquare :: Gregory Flap @ Ronnie’s Diner – With LA Roadrunner’s Alice, Nancy, Tara, Mary after 13 Miles (@ Ronnie’s Diner)
    • Off soon to Venice Beach with the LA Roadrunner’s & … on Twitpic – Off soon to Venice Beach with the LA Roadrunner’s & LA Marathon Training. Today = 13 miles and then Ronnie’s Diner
    • @Flap Twitter Updates for 2011-11-19 | Flap’s Blog – FullosseousFlap’s Dental Blog – @Flap Twitter Updates for 2011-11-19 #tcot #catcot
    • U.S. Facing What Some Call a Dental Crisis – Roughly half of all Americans don’t have dental insurance, and PBS NewsHour correspondent Betty Ann Bowser is calling it a dental crisis. She states in the report that:

      The federal government has identified more than 4,500 areas of this country, like Grundy, Va., where there are not enough dentists. It says nearly 10,000 new providers are needed to meet the need.

      The state of dentistry today is at a point where many are calling for change, and soon.

    • Video: Millions of Americans Face Life Without Dental Care – The lack of access to dental care is a problem that affects millions of Americans. Health correspondent Betty Ann Bowser reports.
    • Is General Dentistry Dead? – Correct. The ADA has been, and still is against a mid-level provider. Feeling that the patient deserves treatment by a dentist.

      The push for a mid-level has come from a combination of legislators being pushed by “patient advocacy groups” (then again one can ask them the question if they’ve ever actually asked the folks their apparently advocating for if THEY want to be treated by a “second tier” provider or a dentist – answer – they haven’t). Groups such a Kellog and Pew who tend to fund many of these studies when looked at closely, aren’t exactly the most impartial of groups (remember who with a research paper one of the 1st things yu should do is not look at the results, but look at who is funding the research in the 1st place to see if from the start the potential for bias exists).

      Additionally on the legislative front, if you ever have the chance to talk with one of your elected officials about this (and I would encourage you to, since they like to listen) is that what dentistry needs to do is not get into the whole “access to care” issue, but the UTILIZATION of care discussion. Access to care in theory would provide access to 100% of people. However, the reality is that even with *cough*free*cough* care the UTILIZATION rate is at best about 60%. The reality is that unless your talking a military style system where going to the dentist is mandatory, there is a very significant portion of the populaton that will not seek out dental care (unless its an EXTREME emergency situation) no matter what. There is plenty of dentists available to handle to demands of the populatin with its current utilizaton rates. Trying to develop a system for 100% access will just end up wasting dollars on that significant population that won’t seek care. If those dollars are directed at existing providers to make the reimbursement rates FAIR, that will have a much greater impact on access. The bottomline is that the overhead for a mid level won’t be any less than that for a dentist, and if a midlevel is getting the same rates for a procedure as a dentist is (and one would sumise that would be the case since in the medical world a nurse practitioner gets the same reimbursement for suturing up a laceration as an MD/DO does) then they’ll have te same problems meeting overhead as a dentist would. The key is that dentistry, when talking about this issue needs to stick to the objective data, which can be tough when the opposing side tends to have mor emtoional “data” than objective data

    • The Afternoon Flap: November 18, 2011 | Flap’s Blog – FullosseousFlap’s Dental Blog – The Afternoon Flap: November 18, 2011 #tcot #catcot
  • Dentistry

    The Cease and Desist Letter From the Smile Center of San Antonio and Dr. Stephen Simpton

    November 16, 2011 /
    Today, after receiving my neat new crown (thank you, Dr. Dovidio), I went over to my old mailbox at The UPS Store (where my wife has a mailbox) and received an old certified letter (from two weeks ago) from a Texas law firm. It was a cease and desist letter over a link I posted here some time ago.I won’t bore you with the details of the letter, nor scan it, but it essentially said stop publishing nasty stuff about our client Dr. Stephen Simpton. Unfortunately, sir, Mr. Jon Michael Smith, Attorney at Law in Austin Texas, a free press does not quite work this way – as I am sure you really know.Here is a video of Dr. Simpton being interviewed by a local San Antonio TV station:

    Fair enough and here is the latest video from WOAI-TV and the some of the problems at the Smile Center.

    Apparently, there are criminal and civil investigations of the Smile Center.

    A criminal investigation is underway into a chain of dental clinics here in San Antonio that targets children on Medicaid. This comes after an investigation by News 4 WOAI Trouble Shooter Brian Collister uncovered complaints of poor treatment at The Smile Center.

    The Texas Attorney General now confirms it has launched criminal and civil investigations into The Smile Center.

    The Attorney General’s office wants to know if the clinics defrauded medicaid by billing for dental work that did not need to be done. The Trouble Shooters have been reporting since February about complaints from parents who say the clinics did unnecessary and shoddy work on their children.

    These parents were unhappy with dental work done on their children and paid with millions of your tax dollars through Medicaid.

    A representative from the Attorney General’s office confirms it’s Medicaid fraud control unit has 180 bankers boxes of records taken from The Smile Center locations here in San Antonio. The agency’s civil Medicaid department has also filed a complaint in civil court against the business. But we don’t know what’s in that complaint because it’s sealed.

    A local law firm is also just weeks away from filing a massive lawsuit against The Smile Center on behalf of the parents of one hundred former patients.The Smile Center’s owner, Doctor Stephen Simpton, recently filed a lawsuit against WOAI and reporter Brian Collister. Simpton claims our stories defamed and disparaged him and his business. Simpton did not respond to a request for comment for this report.

    The attorney for Dr. Simpton responded:

    The attorney for The Smile Center said in a statement. “The investigation to which you refer is a routine Medicaid audit. It has no criminal implications and is not the result of any prior allegations against Dr. Simpton or The Smile Center.  In regard to the lawsuit to which you refer, Dr. Simpton has no comment other than the litigation will take care of itself.”

    Now, a number of patients have filed lawsuits.

    A chain of dental clinics here in San Antonio is hit with a massive lawsuit filed by parents who took their children to The Smile Center.

    The court action is more fallout from my investigation into the clinics and allegations it did unnecessary work at taxpayers expense.

    The lawsuit filed Wednesday on behalf of 23 children alleges the Smile center would routinely recommend unnecessary and excessive dental services.

    The lawyer filing the suit says this is the first of many to come as they prepare to file on behalf of one-hundred children.

    “The lawsuit alleges and we intend to prove with substantial evidence that a lot of the dental care received by these children was unnecessary and improper”, says Attorney Tom Crosley.

    The lawsuit was filed against The Smile Center, owner Dr. Stephen Simpton and former Smile Center dentist Dr Mark Hong.

    It alleges Smile Center and its dentists would – “recommend unnecessary and excessive dental services, most commonly consisting of pulpotomies (baby root canals) and stainless steel crowns”.

    The lawsuit goes on to allege “The smile center subjected these children to its production machine for one primary reason — to bilk Medicaid for its financial gain”.

    The suit also alleges the clinics made $55 Million from Medicaid from 2008 to 2010.

    OK, now the reporting has been done on Dr. Simpton and the problems he is facing. If Dr. Simpton or his attorney wish to comment on these allegations, they are welcome to do so in the comments below or they can use the contact information above (please note, I have a new mailing address).

  • Dentistry,  Dr. Tommy Murph,  The Daily Extraction

    The Daily Extraction: Dr. Tommy Murph’s Costa Rica Extraction Courses

    November 11, 2011 /

     

    Video of the Oct. 23-28, 2011 Hands On Extraction Clinic in Flamingo Beach, Costa Rica

    Dr. Tommy Murph of Daily Extraction fame is giving another tooth extraction course in Costa Rica.

    Here are the details:

    • Saturday March 17 thru Wednesday March 21 in Tamarindo, Costa Rica
    • Saturday June 30 thru Wednesday July 4 (Location not set yet…To be determined by December 5th)

    If you really want to learn how to perform simple extractions, surgical extractions and surgical extractions of third molars, give these courses a look.

    The details:

     

    • Class:  Hands On Extractions
    • Credits: Forty (40) Hours AGD PACE Approved
    • Dates: Saturday March 17 thru Wednesday March 21
    • Cost: $4000 
    • Lecture will be Given Saturday Night 6:00pm-9:30pm 
    • and all day Sunday 8am-9:30pm
    • and Monday night 7pm-until finished
    • Clinical Hands On will be all day Monday, Tuesday, Wednesday
    • Location: Tamarindo, Costa Rica

     

    More information can be obtained from Dr. Murph: drtommymurph at yahoo dot com or by phone: 843-488-4357

    Dr. Murph’s website is here and his extraction manuals are here on e-Bay.

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    The Daily Extraction Archive

  • Animals,  Dentistry,  Heartland Dental Care

    Heartland Dental Care Signs Consent Order Granting Permanent Injunction With North Carolina Dental Board

    October 11, 2011 /

    Heartland Dental Care has signed a consent order with the North Carolina Dental Board.

    The Flap is about the illegal transfer of ownership of a dental practice, owned by a North Carolina dentist, Gary Cameron to Heartland Dental Care in violation of North Carolina law.

    Here is the consent order.

    Heartland Consent Order Granting Injunction 9-6-11

    And, the two dentists (Dr. Gary Cameron and Dr.Peter Son) involved in the buy-sell transactions were disciplined by the North Carolina Dental Board.

    Here is Dr. Gary Cameron’s Consent Order in lieu of an Administrative Hearing.

    At issue is North Carolina law called the Management Arrangement Rule (MAR) which was enacted by the North Carolina Legislature to protect the health and welfare with respect to the practice of dentistry.

    They enacted the MAR to effectuate the Legislature’s mandate in the Dental Practice Act that the ownership of dental practices by unlicensed corporations and entities is prohibited because of the concern that when corporations which are unlicensed to practice dentistry gain improper control over dental practices, patient care may become secondary to profits thereby creating an endangerment to the public.

    Here is Dr. Cameron’s Consent Order.

    Cameron Gary – CO Aug 11

    Dr. Peter Son, Dr. Cameron’s Associate accepted an official reprimand from the North Carolina Dental Doard for his involvement with Heartland Dental Care.

    Here is the reprimand.

    Son Peter – Ltr of Reprimand Aug 11

    So, what does this all mean?

    Heartland Dental Care, a dental management corporation, attempted to purchase Dr. Gary Cameron’s dental practice in violation of North Carolina law. They tried a series of agreements and contracts to skirt the law which prohibited them from a controlling interest in owning a dental practice.

    Heartland Dental Care was caught, signed a punitive consent order with a permanent injunction and paid a fine.

    Both dentists were disciplined.

    In North Carolina, a licensed dentist MUST own and control a dental practice, not an unlicensed, business entity.

    And, dentists are on notice, that should they be tempted to engage in business practices of selling their offices/practices unlawfully, they will have their dental licenses at stake and will be disciplined.

  • Bisphosphonates,  Dentistry,  Fosamax,  Oral Bisphosphonates

    FDA Panel Says Bisphosphonates Need Label Changes on Use Duration

    September 9, 2011 /


    This is the recommendation that came down today although the Food and Drug Administration does not have to accept the recommendations of its panels.

    Bone drugs from Warner Chilcott Plc, Roche Holding AG, Merck & Co. and Novartis AG need labeling changes to reduce the risk of fractures, a U.S. panel said.

    The companies should add clarifications on the length of time that osteoporosis patients may take the medicines, outside advisers to the Food and Drug Administration said today in a 17- 6 vote in Adelphi, Maryland. The FDA isn’t required to follow its panels’ recommendations.

    The agency has evaluated the safety of the drugs, known as bisphosphonates, for almost four years and cited possible links to unusual thigh fractures and jawbone deterioration in 2010. The agency said in July it also was examining conflicting studies on whether bisphosphonate pills such as Warner Chilcott’s Actonel, Merck’s Fosamax and Roche’s Boniva raise esophageal cancer risks.

    A revised label should “be very clear that efficacy may fall off after a period of time, perhaps five years,” panelist Lewis Nelson, director of the medical toxicology fellowship program at New York University, said after the vote. “Serious concerns have been raised about risk, and those need to be continually evaluated as well.”

    There needs to be additional research, period.

    Mere warning labels are not going to answer the questions from every day patients – how long do I take the medicine and what protocol do I use? Or, what is the chance my femur will fracture or will I develop osteonecrosis of the jaw (ONJ) if I have a tooth removed.

  • Dentistry,  Fosamax,  Oral Bisphosphonates,  Osteonecrosis

    Fosamax Osteonecrosis of the Jaw Lawsuit Set for Trial September 7

    August 29, 2011 /

    Osteonecrosis of the Jaw (ONJ)

    Another oral bisphosphonate (Fosamax with ONJ) lawsuit trial set.

    The next trial date for a Fosamax lawsuit involving jaw necrosis is scheduled to begin early next month.

    The Fosamax trial will involve a complaint brought by Linda Secrest, of Florida, who alleges that Merck failed to adequately warn that side effects of Fosamax, the popular osteoporosis drug, can lead to severe jaw bone decay. Trial is scheduled to begin on September 7, in the U.S. District Court for the Southern District of New York.

    Fosamax is an osteoporosis drug that belongs to a family of similar medications known as bisphosphonates. Long-term use of oral bisphosphonates has been linked to an increased risk of serious and debilitating jaw problems, known as osteonecrosis of the jaw. The condition causes the jaw bone to decay and rot, often resulting in the need for surgery to remove portions of the jaw.

    Merck currently faces more than 1,100 Fosamax jaw lawsuits, most of which have been consolidated and centralized for pretrial proceedings in the U.S. District Court for the Southern District of New York as part of an MDL or multidistrict litigation.

    There have already been several trials for Fosamax jaw necrosis lawsuits that have been held in the federal MDL over the last two years. While Merck has successfully defended its medication in three cases, one lawsuit resulted in an $8 million jury award for Fosamax jaw damage last year, finding that Merck failed to adequately research the potential side effects of warn about the risk of jaw necrosis from Fosamax.

    A few more cases and Merck will probably propose some industry-wide settlement agreement.

    Next up will be the lawsuits over bone fractures from Fosamax.

  • Dentistry

    Video: Will A Cavity-Filling Fluid Replace the Dental Drill?

    August 24, 2011 /

    Well, perhaps, some day.

    Perhaps someday, the bi-annual trip to the dentist may become much less intimidating, thanks to researchers at Leeds University in the UK who have developed a completely pain-free way to fill cavities.

    Taking inspiration from the principles of regenerative medicine, the process involves a special peptide-based fluid. Suspended in water, the peptide fluid, known as P 11-4 is clear and has a similar viscosity as water. Under certain conditions, namely when placed in contact with saliva that surrounds a tooth, the fluid forms a gel scaffold that fills the microscopic holes that are cavities. The scaffold, which mimics proteins that are found in growing teeth, attracts hydroxyapatite and other minerals to regenerate actual tooth enamel within weeks.

    You can read more here.

    Dentistry has been awaiting a “Magic Mouthwash” to treat caries and periodontal disease for decades.

    Has the future arrived?