South Royalton’s HealthHUB pursues breakthrough at Dental Board Jan 11

For Immediate Release
Thursday, Jan 5, 2023

Rebecca Foulk, MD, South Royalton,, 763-8426
John Echternach, DDS, Strafford,, 765-9648
Bob Frenier, Chelsea,, 685-4900

On Wednesday, January 11 at 9:00 AM, the VT Board of Dental Examiners (BDE) will hear HealthHUB’s own Dr. John Echternach (and others) ask the BDE to expand the scope of practice for Registered Dental Hygienists (RDHs) to allow them to provide Medical Management of Caries (MMC) restorative care, not just preventive care.

What’s the big deal?

Well, there are 170,000 Vermonters (27% of total VT population) eligible for Medicaid benefits and those benefits don’t pay dentists enough per cavity for most dentists to be willing to drill and fill all those cavities. So, for all practical purposes, Medicaid beneficiaries don’t get any dental care.

But MMC is a well-established treatment that can be applied very quickly to a cavity, much faster than drilling and filling it. If you put that speedy treatment together with the lower wages RDHs earn, it creates a whole new financial calculus that makes getting a healthy mouth financially possible for the first time ever for all 170,000 Medicaid beneficiaries … and a whole bunch of other low-income Vermonters, too.

Having a healthy mouth, without the infections that cause cavities, helps keep the whole body healthy because those infections don’t travel to infect other organs in the body. That’s a very big deal and you can ask any physician about it. HealthHUB is building two mobile dental operatories to take MMC to residents and school children in a dozen towns around South Royalton, if the BDE approves.

The BDE meeting is via zoom and is open to the public (you can ask questions). An explanation of MMC is below and Dr. Echternach can provide you with a more complete explanation. And at least 170,000 Vermonters (plus every medical/dental professional in VT) will be vitally interested in how the BDE rules on the request to “increase the scope of practice for Registered Dental Hygienists.”

Vermont Board of Dental Examiners (802-828-2390) is located at National Life Building, Montpelier, Vermont 05620-3402. Corey Young at the BDE is a good one to call to learn the best way for you to participate.

*How Medical Management of Caries works: Peripheral areas of the decayed tooth can be gently removed with a non-mechanical hand tool or a low-speed drill, which does not require an anesthetic or use of a high-speed drill. Silver Diamine Fluoride (SDF) will be applied painlessly to the cavity to kill the infection and begin to remineralize the damaged tooth structure. A filling material called “Glass Ionomer” will painlessly fill the cavity, binding itself to the tooth and this material also helps to re-mineralize the decayed area. That prevents the infection from spreading to other teeth, stops further/deeper penetration of the lesion into the tooth, and makes the decayed area stronger. The resulting reduction of infection contributes significantly to patients’ overall health.

Image courtesy of Wikimedia Commons/Cukierspace

4 thoughts on “South Royalton’s HealthHUB pursues breakthrough at Dental Board Jan 11

  1. Question: how long does it take to get in to get your teeth cleaned? Some need to be seen every 3 months to prevent tooth loss. There is a severe shortage of dental hygienists in Vermont mostly due to the pandemic and failed dental therapy program. You know the one that pays hygienists way less to do what dentists do because you really don’t need a doctoral degree to do surgery on someone. So the legislature approved such a program years ago but you don’t want to wait until they are trained to know what to do?
    The cost itself is another issue. Tell that dentist who graduated with $500,000 in debt he can’t charge enough to pay back his loans! That’ll fix it. Most dentists only charge what insurance allows them to charge. Why aren’t the FQHC’S taking care of this issue? They get paid more for every visit by a Medicaid patient than a private dentist. They also get kickbacks from suppliers to help lower their costs.
    Help us educate and fix the system instead of pointing fingers at healthcare providers!

  2. It is my pleasure to know and have worked with in one way or another Bob Frenier, Rebecca Foulk and John Echternach. My eldest son did some logging for Bob Frenier as well. The commitment of these three poeple to providing needed dental care for those who need it and their skill and knowledge in their fields is impressive. They also enjoy working with each other on this project despite the fact that they are miles apart politically.

    In this time with so much division, I have found working on Lions Club projects that benefit our communities, often with people who have different political views, is something I too enjoy.

  3. This post is intended for dentists:
    MMC is fantastic news. It is a criminal tragedy that low income/poor people have to live with rotten and/or no teeth, poor health and shortened lives. It’s easy to blame them for not taking care of their teeth, and I am tempted to do so myself except, I recognize the problem is deeply entrenched in low-income psychology and multi-faceted.

    Even older people who have taken care of their teeth with regular dental care and daily brushing and flossing have become victims of greedy dentists, they cannot afford the 1000s of dollars for more intensive care to maintain keeping all of their teeth. Because even with good care bone shrinks and teeth come out.

    But this is the statement that is most disturbing:
    “… there are 170,000 Vermonters (27% of total VT population) eligible for Medicaid benefits and those benefits don’t pay dentists enough per cavity for most dentists to be willing to drill and fill all those cavities.”
    How much is enough? This article should have included what dental care costs these days? It’s criminal. Dentists have become greedy capitalists?

    I hope TNR will follow-up with the cost of dental care in this state.

  4. Also related to modern Dental practice is the problem of the Root canal. There are over 300 feet of microscopic tubules in each tooth. Merely cleaning out the contents of the root canals (3 or 4 per tooth) does not prevent future decay as the tubules are essentially rotting in the tooth. There is a least one company, Fotona, which produces the Lightwalker line of hard and soft tissue dental lasers. Applying the laser to the tooth causes the tubules to empty (red goo) and future infection is greatly reduced. It is a painless procedure.

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