Sarah Handzel, BSN, RN

A recent report found that Denti-Cal dentists were reimbursed at a rate of about 35 percent of the current national average for common procedures.

 for low-income individuals and families, is the focus of two new bills going before state lawmakers. The proposed legislation aims to improve the program and expand access for residents of California, in addition to increasing dentists’ reimbursement through program participation.

According to a report in California Healthline

, Assembly Bill 753 would use money from California’s new tobacco tax to expand access to the Denti-Cal program. The bill would also require that dentists receive greater reimbursement for 20 of the most common dental procedures, such as X-rays and fillings.

 showed that, for the most common dental procedures, Denti-Cal reimbursement rates averaged about $21.60, which is only 35 percent of the current national average. As a result, many dentists in the state do not participate in the program simply because they cannot afford to.

The new tobacco tax is expected to generate up to $1.2 billion in the coming year, and if the new bill passes, $300 million would be earmarked for Denti-Cal improvements. Much of the funds would be allocated for payments to dentists who provide preventative dental care to adult patients. The state already has one program, the 

, that provides extra reimbursement, from state and federal dollars, to dentists who provide preventative services to pediatric patients.

Assembly Bill 15, which was introduced late last year, would also help improve payment rates for dentists in the state by requiring reimbursement to be doubled for the 15 most common prevention and treatment services.

However, some dentists in California are concerned that the proposed legislation will not be enough to entice more dentists into the Denti-Cal program. John Blake, D.D.S., explained that, while expansion of the Denti-Cal program could help increase access to preventative care, many adults already have complicated dental problems. Dentists could find themselves between a rock and a hard place if these issues are detected during routine cleanings or other basic screening procedures.

, “The adult population is a different beast from a treatment standpoint. We’ve done all this cleaning, but now we need root canals and extractions…how do we cover this?”

Assembly Bill 15 will be reviewed by the Assembly’s Committee on Appropriations, but a hearing date has not yet been scheduled. In the meantime, many dentists believe that using tobacco tax money to expand the Denti-Cal program and increase payment rates makes sense, even though there are still many questions regarding adult patients’ potential dental issues. According to Blake, most dentists are simply seeking reimbursement that matches the national average, even with California’s higher cost of living and business costs.

Articles

California legislators may soon overhaul its state-run dental program for low-income individuals and families. Two bills are making their way through the state legislature. One would expand the program, granting more access to residents. The other would increase dentists' reimbursement through program participation.

Proposed Bills Seek to Improve Denti-Cal

If you’ve ever wondered just how much of the taxes you pay go toward improving and increasing access to government services, you’re not alone. Recently, WalletHub analyzed data from several sources in a 

 to see where taxpayers are actually getting the most return on investment (ROI) for the taxes they pay.

State and local taxes collected were contrasted with the quality of public services provided within five predetermined categories: education, health, safety, economy, and infrastructure and pollution. Twenty-three key metrics were included in the analysis to help determine which of the 50 states provided taxpayers with the most bang for their buck, with a score of 100 indicating the best quality of government service. Previously, 

 — but for each state with good rankings, there must be corresponding states with poor rankings.

· Vermont received a health ranking of 30 out of all 50 states.

· In terms of economy, the state is ranked at number 27.

· According to WalletHub, Nevada’s hospital systems are some of the worst countrywide.

· The state also has one the highest violent crime rates in America.

· Wyoming has more total taxes per capita compared to many other states.

· However, the overall government services rank only comes in at number 17.

· The health rank for the state of Delaware came in at number 49.

· The overall government services ranking for the state was number 29.

· A high percentage of residents are living in poverty in Arkansas.

· Overall, government services for this state were ranked at number 44.

· The state of New York has some of the worst hospital systems in the nation.

· New York also has one of the worst water quality scores nationwide.

· Residents of California typically pay more taxes than residents of other states.

· Even though the tax rate is higher, the quality of governmental services doesn’t rank very high — the state comes in at number 32.

· According to WalletHub, New Mexico’s school systems are the second worst in the country.

· New Mexico has the third highest violent crime rate nationwide.

· This state has the third worst roads and bridges out of all 50 states.

· Hawaii also has the third worst water quality when compared to other states.

· Residents of North Dakota pay more in taxes than in any other state.

· Even though more taxes are collected here than anywhere else, the state only ranks at number 9 for overall quality of governmental services.

What services are you getting in return for the state taxes that you pay? In its latest analysis, WalletHub looked at the return on investment taxpayers are getting in each state. Dentist's Money Digest® previously reported on the study, highlighting where the tax ROI is best. Unfortunately for residents in these states, this is where it's worst.

10 States with the Worst Taxpayer ROI

2017’s Tax Day has come and gone, and, if you’re like many, you might think you pay too much in taxes anually. Many Americans also think federal and state governments waste much of the money collected from taxes, and many estimate that more than half of each tax dollar is wasted.

Considering this apparent disconnect in the minds of millions of taxpayers, WalletHub analyzed data from several sources in a 

 to see where taxpayers are getting the most return on investment (ROI) for the taxes they pay. State and local taxes collected from taxpayers were contrasted with the quality of public services provided within five predetermined categories: education, health, safety, economy, and infrastructure and pollution. Twenty-three key metrics were included in the analysis to help determine which of the 50 states provided American taxpayers with the most bang for their buck, with a score of 100 indicating the best quality of government service.

· This state boasts the lowest percentage of residents living in poverty.

· New Hampshire also has the fourth lowest violent crime rate in the nation.

· South Dakota has the fourth best hospital system in the country, according to the analysis.

 in total taxes paid per capita, counting only individuals aged 18 and older.

 in total taxes paid per capita, one of the lowest tax rates nationwide.

· This state has the fourth best roads and bridges nationally.

 lowest violent crime rate in the country.

· The state comes in at number 15 for total taxes paid per capita.

 lowest percentage of residents living in poverty.

· Total taxes paid per capita is ranked at number 1, the best out of all 50 states.

· Out of a possible high score of 100, Colorado’s government services ranking was 61.65, the 11

· This state is number 1 in the country when it comes to the best hospital system.

· Utah’s government services ranking was 64.19, the 10

· Total taxes paid per capita was ranked at number 5 for the state of Missouri.

· The overall government services ranking for this state was 37.

· Government services received an overall rank of 28 in the state of Texas.

· The economy in the state was ranked 11

· Government services in the state of Nebraska are ranked at the 4

 best in the country, while infrastructure and pollution was ranked at the 5

WalletHub, in its latest analysis, looked at what residents are getting in return for their state tax dollars. Criteria for evaluation included education, health and safety, among others. Here's how the top 10 states stack up.

10 States With The Best Taxpayer ROI

, an all-tissue laser system that is now available for purchase to dentists in the U.S. The system is the fifth generation of the world’s most widely used all-tissue dental laser wavelength, and it offers several key features and upgrades to help make patient care easier and more successful. The system is approximately one-quarter of the size of the company’s Waterlase iPlus system.

Dmitri Boutoussov, BIOLASE Chief Technology Officer and PhD, 

, “When we began this project, our goal was to create a new version of Waterlase that would be a much smaller, simpler, more reliable and cost-effective system, while still carrying all the benefits of powerful Waterlase laser technology. We designed Express so that every dentist, whether completely new to lasers, or a pro, can easily learn Waterlase Express and start using it, with integrated support by BIOLASE and its network of educators and peer practitioners.”

The Waterlase Express laser system features several new technological advances, including 4K HD animations detailing each step of many common dental procedures. The system is designed for use in restorative, soft-tissue, periodontal, endodontic, and implant procedures. Other technological improvements include:

· Cloud-based software that allows for easier learning, remote diagnostics, and support for dentists

· A newly patented contra-angle handpiece designed for better intraoral access and improved comfort

· A compact, miniaturized version of the laser engine

Also, the new design includes many tools that offer support and opportunities for further educational achievement. These 

· Step-by-step protocols for both periodontal and implant procedures

· Detailed instructions for pediatric and deciduous tooth procedures

· A library of more than 80 clinical procedures, including simplified and intuitive clinical workflows

· One-touch access to BIOLASE Customer Care whenever dental practitioners require assistance

· Video tutorials to make maintenance and care of the system easier

· BIOLASE Connect, a system that allows dentists to connect with other supportive resources

U.S. dentists can now purchase BIOLASE's Waterlase Express. The new Waterlase Express is about a quarter of the size of the company's Waterlase iPlus system. New features include 4K HD animations that demonstrate each step of procedures and step-by-step protocols for periodontal and implant procedures.

BIOLASE Launches New All-Tissue Laser System

The sponsor dental groups estimate that nearly $500 million is spent each year to treat sports-related oral injuries.

Five dental organizations, including the 

American Association of Oral and Maxillofacial Surgeons

the American Association of Orthodontists

 to help educate the public on protection against facial injuries. The collaboration is in honor of 

How Medicaid Expansion Has Affected Dentistry

Group Works to Expand Medicare to Include Dental Coverage

Researchers Use Tooth Germ to Regenerate Teeth in Animal Study

Almost $500 million is spent yearly to treat teeth that are injured or knocked out due to sports-related injuries. It is important to raise awareness of these types of injuries and the methods people can use to prevent them from occurring, especially since the weather is warmer and people are participating in outside activities more often.

According to the collaborating organizations, athletes in every type of sport should be encouraged to wear mouth guards, which can help prevent mouth injuries from occurring. Dentists are already prepared, in many cases, to fit and manufacture mouth guards, but consumers can also get them from commercial retailers and some drug stores. Patients and their families should be encouraged to wear other types of protective gear, including helmets, that could help prevent more serious injuries to the mouth or face.

In addition to the protection offered by mouth guards and other safety equipment, these types of products are a more cost-effective option compared to the expenses incurred while fixing injured or damaged teeth.

The five organizations that have teamed up advise that any type of mouth protection should be strong, light, custom fitted, and easy to clean. The protective equipment should also be the right size and fit over both the gums and the teeth. Dentists and dental specialists should be prepared to consult with patients regarding their unique needs, and to recommend appropriate mouth protection based on the type of activity.

Discover more Dentist’s Money Digest® news here

April, in addition to being Oral Cancer Awareness Month, is also National Facial Protection Month. Five dental organizations have teamed up to promote the use of mouth guards in sports. They note that nearly $500 million is spent each year to treat damaged or knocked-out teeth. The cheaper solution for dental patients: wearing a mouth guard. 

Dental Organizations Collaborate for National Facial Protection Month

See if your state landed among WalletHub's list of 10 states with the lowest tax burdens.

This time of year, with Tax Day having just come and gone, the pockets of many dentists are feeling a little bit lighter after the federal government has collected what was owed.

If not you, then your CPA is well acquainted with how your tax rate is calculated. Several factors determine your rate, including your yearly income and your marital status. But did you know that you can gauge how hard you’ll be hit each year by looking at your state’s tax burden?

The 10 Least Tax-Friendly States for Businesses

The 11 Highest-Paying States for Dentists

The tax burden of your state is different from your tax rate. Instead of calculating what you personally owe based on individual factors, your state’s tax burden is a measurement of the total personal income that residents pay toward different state and local taxes. Tax burdens vary widely across the U.S., with some states paying significantly less in taxes than others.

WalletHub has analyzed the 50 states’ tax burdens

 and determined which states’ residents enjoy paying less. The analysis compared every state by looking at three tax types — property tax, individual income tax, and sales and excise tax. Then, they ranked these numbers as a percentage of total personal income in each state.

Click next to see which 10 states have the lowest tax burdens, starting with number one:

· People living in Delaware have the lowest tax burden countrywide, with only 5.59 percent of their personal income going toward state and local taxes.

· On average, residents of Delaware have the second lowest property tax burden in the nation, totaling 1.83 percent of their personal income.

· The average individual income tax burden for people living here is 0 percent of residents’ total personal income, the lowest in the U.S.

· People living in Alaska typically pay 1.43 percent of their incomes in sales and excise taxes each year, also the lowest amount countrywide.

· The total tax burden for the state of Tennessee is only 6.45 percent.

· A 2.06 percent overall property tax burden helps residents pay less each year.

· On average, the individual income tax burden for people living in Oklahoma is only 1.69 percent.

· Oklahoma also has the fifth lowest overall property tax burden in the country, totaling 1.38 percent of personal incomes.

· People in New Hampshire save money each year, since their total tax burden is 6.70 percent.

· New Hampshire also has the third lowest sales and excise tax burden, totaling 1.24 percent of personal incomes.

· The state ties Alaska in lowest overall individual tax burden — 0 percent for residents of the Sunshine State.

· Floridians also enjoy low property tax burdens totaling an average of 2.76 percent of individual income.

· The total tax burden for people living here is approximately 7.12 percent.

· Along with Alaska and Florida, individual income tax burden is 0 percent of total personal income in this state.

· Residents enjoy the fourth lowest property tax burden in the country, averaging only 1.41 percent of their personal incomes.

· The excise and sales tax burden is also a small percentage of personal income, totaling 3.93 percent each year.

· State residents shoulder a 0 percent individual income tax burden while living in Wyoming, matching Alaska, Florida, and South Dakota.

· The property tax burden is slightly higher, coming in at 3.77 percent of personal income.

· Montana’s overall tax burden is 7.51 percent of total personal income.

· People living here have a low sale and excise tax burden, only 1.34 percent of total personal income.

Discover more Dentist’s Money Digest® news coverage here

Has the tax man left your pockets feeling a little light? With Tax Day having come and gone, many dentists are left smarting. The good news is that when it comes to taxes, the grass may actually be greener in another state. The number-crunchers over at WalletHub recently released their complete ranking of tax burdens on a state-by-state basis. These are the states that enjoy the lowest tax burdens.

10 States with the Lowest Tax Burdens

WalletHub used 33 key indicators of stress to rank individual states and the District of Columbia, with each indicator assigned a corresponding value. Each state was graded using varying types of data, including the average number of hours worked weekly, the personal bankruptcy rate, and the number of adults in the state who get adequate sleep each night.

· A score of 56.91 makes this state the most stressed for 2017.

· Alabama also has one of the highest percentages of adults living with a fair or poor health condition and the fewest number of psychologists per capita.

· People in Louisiana have some of the lowest credit scores nationwide.

· This state also has one of the highest crime rates per capita.

· A high percentage of people in Mississippi are living below the poverty line.

· Mississippi also has one of the highest divorce rates in the country.

· A high percentage of adults in West Virginia are living in fair or poor health.

· Unfortunately, people in this state also have some of the lowest job security in the country.

· People in Kentucky also have lower job security compared to people in other states.

· Those living in this state are also more likely to get fewer hours of sleep every night.

· New Mexico has one of the highest rates of crime per capita.

· A large proportion of the state’s residents are also living under the poverty line.

· Nevada’s divorce rate is higher compared to other states.

· There are fewer psychologists per capita in Nevada than in other states.

· Residents of Georgia typically have lower credit scores compared to people living in other states.

· People living here are also getting fewer average hours of sleep than those living elsewhere.

· A score of 51.93 makes Tennessee the 9

· There is a high percentage of people living here who are in fair or poor health.

· Arkansas also has a high crime rate per capita compared to other states.

Feeling a bit on edge lately? We are, to a certain degree, products of our environments. And if you're living in these 10 states, your environment could be spiking your overall stress levels. The number-crunching gurus at WalletHub used 33 criteria to rank the most stressed-out states of 2017. Find out if your state landed among the top 10.

The 10 Most Stressed States of 2017

It’s no secret that stress can have profound effects on your life, both professionally and personally. The good news is that we’re finding out just how damaging prolonged exposure to stress can be, and we’re investigating the ways to remove stress from our lives as much as possible. 

According to the American Psychological Association

, Americans’ stress levels in 2016 were at their lowest levels in 10 years. But in 2017, those levels are starting to tick back up, in some states more than others.

WalletHub has ranked the 10 most and 10 least stressed out states

 using 33 key indicators of stress, including average hours worked per week, personal bankruptcy rate, and the number of adults who are getting adequate sleep each night. All 50 states and the District of Columbia were included in the analysis, with each of the 33 indicators corresponding to a ranking score. A score of 100 was equal to the highest stress level possible.

Click the next page to see the rankings of the 10 least stressed out states, starting with number 1.

· A score of 38.41 ranked this state as the least stressed in America.

2016 Most and Least Stressed Cities analysis

, Madison, WI boasts the fewest average hours worked each week, in addition to the most psychologists per capita.

· This year, Colorado received a score of 37.28, making it the second least stressed state in the country.

· Colorado earned high marks for the most average hours of sleep a person got each night.

· A score of 36.27 makes Vermont the third least stressed state in America this year.

· Compared to other states, people in Vermont tend to work less than people elsewhere.

· Residents of this state enjoy a higher standard of living — compared to other states, New Hampshire has one of the lowest percentages of people living below the poverty line.

· New Hampshire residents are also among the lowest percentage of adults in fair or poor health.

· People in Nebraska know how to handle their cash - residents tend to have higher average credit scores compared to those in other states.

· Nebraska also has some of the most affordable housing in the country.

· In Utah, residents are in it for life - the state has one of the lowest divorce rates in the country.

· People in this state also work less compared to people in other parts of the country.

· While markets in other areas are pricing many people out, residents of South Dakota enjoy some of the most affordable housing options in America.

· People living in this state enjoy more sleep every night compared to people living elsewhere.

· Iowa residents are fortunate to be living in a state with one of the lowest percentages of adults with a fair or poor health condition.

· People living in this state also have access to more affordable housing.

· Like its southern neighbor, North Dakota boasts more affordable housing options compared to other states.

· People here also seem to be happier together, since the state’s divorce rate is among the lowest in the country.

· Fortunately for Minnesotians, job security is a very real thing — people living here enjoy one of the highest rates of job security nationwide.

· It seems like hard work pays off as well, since people living here also have some of the highest credit scores.

Discover more Dentist’s Money Digest lifestyle coverage here

The American Psychological Association reports that stress levels have crept up across the board in the U.S. in 2017. However, residents in these 10 states, analyzed by WalletHub, might find life a little bit easier. The number-crunchers there ranked all 50 states according to 33 key stress indicators. See if your state made the cut.

The 10 Least Stressed States of 2017

Parents have taken advantage of the Medicaid expansion to provide their children with dental care. But are low-income adults taking advantage of the Medicaid expansion?

Currently, dental coverage under Medicaid is only an optional benefit, but several states and the District of Columbia have expanded eligibility requirements after the passage of the Affordable Care Act (ACA) to allow more people to enroll in the program. A 

 in Health Affairs has been published to understand the benefits and impact of a push for greater enrollment in the program.

New Research Claims Early Preventative Care Leads to Greater Costs

Americans Want Medicaid Expansion Funding Preserved, Poll Shows

New Study Shows Dental Benefits Influence Children’s Dental Needs

For many years, Medicaid has helped families and individuals pay for their health care needs. Many parents take advantage of the program to provide their children with dental benefits, but dental coverage for adults remains an optional benefit.

Previous studies have shown that dental coverage for adults enrolled in Medicaid is a factor in access to and use of dental care among low-income enrollees. In this study, the relationship between yearly dental exams was examined, with researchers attempting to determine if low-income Medicaid enrollees were more likely to use dental care compared to adults with no such benefits. Also, the study looked at the impact of the Medicaid expansion on the use of dental care in both low-income childless adults and parents, specifically in states that do not offer adult dental coverage through the program.

The investigators collected data from 2010-2014 from the Behavioral Risk Factor Surveillance System (BRFSS), a survey that collects self-reported information on preventative health habits and risk factors. In states providing dental benefits to adults through Medicaid, low-income adults did access and receive dental care with greater frequency compared to those without coverage. In fact, enrollees in Medicaid’s dental benefit program had a 9.7 percent greater probability of seeing a dentist compared to residents of states with no such Medicaid benefit.

Childless adults who received dental coverage had a significantly higher probability of dental visits during the study time frame — in 2010, the probability of such adults seeing a dental practitioner was 48.6 percent, while in 2014 the probability had risen to 50.4 percent.

However, in states providing dental benefits through an expanded Medicaid program, enrollees had a decline in the likelihood of seeing a dentist — in 2010, that probability was 52.3 percent, while in 2014 it was only 50.4 percent. In states that expanded their Medicaid programs, the probability of low-income parents seeing a dentist also declined, from 56 percent in 2010 to only 47.9 percent in 2014.

While childless low-income adults might have access to more funding to provide for their own dental health, low-income parents were the driving force behind the decline in dental visits among adults during the study period. The investigators also postulated that the decrease in visits was related to other factors, including dental provider shortages and fewer dentists participating in their states’ Medicaid reimbursement program.

Ultimately, the study concluded with emphasis on the positive impact Medicaid has had on low-income patients, noting that program expansion efforts have increased the use of dental services. However, dental benefits are still optional under the current program, and with the current political climate, it is unknown what any ACA replacement plan would look like, or how they would affect patients nationwide.

A recent Health Affairs study examined the effect of efforts to enroll more people in dental coverage through Medicaid. Currently under Medicaid, dental coverage for adults is optional. This study examined whether low-income adults with Medicaid dental coverage were more likely to access oral health care than low-income adults without the coverage.

Recent research shows that only about 12 percent of Americans over age 65 have dental insurance.

Currently, Medicare does not commonly cover any types of dental benefits for Americans aged 65 or older. 

According to the Centers for Disease Control and Prevention

, almost one in five people in this age group have untreated tooth decay. In an attempt to find coverage solutions that will allow older adults to receive the treatment they need, the Santa Fe Group, a nonprofit think tank, is working toward expanding Medicare coverage to include dental care.

The Business of Saving Lives: Dentistry and The Fight Against Oral Cancer

New Nanocoatings Could Help Prevent Peri-Implantitis

Research has already shown that untreated tooth decay can lead to or exacerbate a variety of health problems, such as heart disease or diabetes. This in turn creates more treatment costs that Medicare ultimately pays. At present, fewer than half of elderly Americans visit a dentist each year, partially because they cannot afford to. Also, 

The Santa Fe Group is working to expand Medicare to include dental coverage for Americans aged 65 and older. Currently, Medicare does not offer this benefit. Citing an increasing body of research that links oral health to conditions such as heart disease and diabetes, the nonprofit is hoping to find sympathetic ears for its lobbying efforts in Washington.