Lance's Corner

NIH Highlights Periodontal Disease

Apr 8, 2024
Per the notice below, the Centers for Disease Control and Prevention (CDC) is highlighting periodontal disease.

Periodontal (Gum) Disease

Overview

Periodontal (gum) disease is an infection of the tissues that hold your teeth in place.  It's typically caused by poor brushing and flossing habits that allow plaque—a sticky film of bacteria—to build up on the teeth and harden.  It starts with swollen, red, and bleeding gums.  If left untreated, it can spread to the bones surrounding the gums, making it painful to chew.  In the worst cases, teeth may become loose or need to be removed.

Information on preventing and treating periodontal (gum) disease and NIDCR’s related research: https://youtu.be/Jcd2sCgFhh4.
Ask the Expert

Timothy J. Iafolla, DMD, MPH answers all your questions about flossing.  Read the interview here.

Causes

Dental plaque that is not removed every day can harden and form tartar, and tartar build-up can lead to gum disease.  Only a professional cleaning by a dentist or dental hygienist can remove tartar.  There are several risk factors for gum disease, but smoking is the most significant.  Smoking also can make treatment for gum disease less successful.  Other risk factors include hormonal changes in girls and women; certain illnesses, such as diabetes or AIDS and their medications; and genetics.

Symptoms

Symptoms of gum disease can affect various areas of the mouth.

 
Affected AreaSymptoms
Gums

Gums may be red, swollen, tender, or bleeding.

The gums may pull away from the teeth making them appear longer.

Teeth

Loose or sensitive teeth.

Pain while chewing.

OtherPersistent bad breath.

Diagnosis

At a dental visit, a dentist or dental hygienist will perform tests to diagnose periodontal disease:

 
Diagnostic Test                    How it’s done                        Why it’s done
Gum ExaminationThe dentist will examine your gums for signs of inflammation and use a tiny ruler called a “probe” to measure pockets around the teeth.In a healthy mouth, the pockets around the teeth are usually between 1 and 3 millimeters.  Deeper pockets can be a sign of periodontal disease.
Medical History SurveyThe dentist will ask questions about your medical history.Certain conditions or risk factors, like smoking or diabetes, can contribute to gum disease.
X-RayX-ray images of the teeth and mouth are taken.An x-ray can show if there is any bone loss as a result of gum disease.

Your dental professional may also refer you to a periodontist, a specialist in the diagnosis and treatment of gum disease, who may provide other treatment options not provided by your dentist.

Treatment

The main goal of treatment is to control the infection.  The number and types of treatments will vary, depending on the extent of the gum disease.  Any type of treatment requires that the patient keep up good daily care at home.  The dentist may also suggest changing certain behaviors, such as quitting smoking, as a way to improve your treatment results.

Helpful Tips

You can keep your gums and teeth healthy by:

  • Brushing your teeth twice a day with a fluoride toothpaste.
  • Flossing regularly to remove plaque from between teeth.  Or, you can use a device such as an interdental (between-the-teeth) brush, a wooden or plastic pick, or a “water flosser” recommended by a dental professional.
  • Visiting the dentist routinely for a check-up and professional cleaning.
  • Quitting smoking.

Additional Resources

  • Periodontal Disease
    Information from the Centers for Disease Control and Prevention about the causes of periodontal disease, its warning signs, risk factors, and prevention and treatment.
  • MedlinePlus: Gum Disease
    The NIH National Library of Medicine's collection of links to government, professional, and non-profit/voluntary organizations with information on periodontal disease and gingivitis.
  • How to Quit Smoking
    Information from the Centers for Disease Control and Prevention (CDC) on quitting smoking.
Older Adults and Oral Health
Fact sheet on maintaining oral health for a lifetime.

Periodontal (Gum) Disease Research from NIDCR

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc