Miles of Smiles, Ltd.

The services that are provided to any child with a positive, fully completed consent slip includes a dental exam, prophylaxis (cleaning), fluoride treatment, and dental sealants, which are placed on appropriate molars to prevent future decay.

The processes by which we provide these services are:

• Our services are available to every county.

  Permission slips are sent home with the children. Once the positive (fully completed) slips are returned, a dental team is scheduled to go to the school. This team may include a dentist, 1-2 hygienists, and 1-2 dental assistants.
  
  
• Services performed are billed to: Medicaid/All Kids, county grantees via the IDPH Dental Sealant Grant Program*, various granting agencies, & private insurance. Miles of Smiles, Ltd. accepts reimbursement status as final payment. Families and schools are never billed for co-payments, deductibles, or balances.

*Miles of Smiles, Ltd. makes an annual donation to each participating grantee/Health Department/Head Start to help facilitate their oral health initiatives. All monies that transact between us for the dental sealant program is awarded back to grantee/Health Department/Head Start after the final billing cycle in June.

Dental Examination
Dental examinations are an important part of every person's overall health care. Patients who perform proper dental hygiene at home still benefit from these examinations because a dentist can discover problems early, while they are easy to treat. Prior to a dental examination, a patient should provide an updated medical history to the dentist. This can identify certain medical conditions or lifestyle choices that may affect a patient's oral health. A dental examination is a process in which a dentist examines the teeth and gums for signs of disease or irregularity. Dental examinations involve a number of components. These may include:

• Visual inspection of the soft tissues inside the mouth (e.g., tongue, cheeks, inner and outer lips, floor and palate of the mouth). This is done by a visual inspection of the inside of the mouth to identify any sores, swelling, growths or other abnormalities that may indicate health problems, such as infection. Visually inspecting the gums for redness or swelling may indicate gingivitis or gum disease (periodontal disease).
• Visual inspection of all teeth for noticeable signs of tooth decay. A mirror may be used to see all sides of the teeth. Problems such as tooth decay may not be apparent to the patient (e.g., cause pain) until they are significant.
• Examination of a patient's bite, which may indicate a need for braces.
• Certain treatments may be recommended, depending on the findings of the examination (fillings, crowns, extractions, braces). In some cases, protective measures such as dental sealants may be recommended.

Dental Prophylaxis (cleaning)
Dental cleanings may be performed by the dentist or by a dental hygienist. This includes:

• Cleaning removes tartar/calculus from above and just below the gum line that can lead to tooth decay and gum disease. At-home dental care removes plaque, but only professional dental instruments can remove tartar build-up.
• Polishing involves the application of a gritty substance/flavored paste to the teeth, which are then buffed with a rotating rubber brush. This removes plaque and surface stains. Patient's mouths are rinsed often during cleaning and polishing.
• The dentist or dental hygienist encourages patients to use proper daily dental hygiene (brushing, flossing), and patients are instructed on the proper brushing or flossing techniques.
• In addition, the patients will be given a free toothbrush, toothpaste, and floss to take home.

The use of fluoride has been endorsed as a safe and effective method of preventing tooth decay. When fluoride enters the mouth it is deposited into the teeth, strengthening teeth during a process called remineralization. Fluoride is a mineral that appears naturally in soil, water, and certain foods. It is often added to community drinking water when levels are deemed insufficient to help protect against tooth decay. Sometimes fluoride supplements (in the form of tablets, drops or lozenges) are used to compensate for drinking water without adequate fluoridation. Fluoride is also directly applied to the teeth as part of routine oral care. Brushing teeth with fluoride toothpaste is an important component of good daily dental hygiene. Fluoride may also be topically applied as fluoride gels, varnishes, mouth rinses, and during professionally applied fluoride treatments. Anyone at high risk of tooth decay may benefit from fluoride treatments that use higher concentration levels of fluoride than those available in over-the-counter products. All age groups can benefit from fluoride, which fortifies and strengthens teeth. Children who receive adequate levels of fluoride develop permanent teeth that are more resistant to decay.
Fluoride is used to protect against tooth decay/cavities and the complications that can result. Tooth decay begins with demineralization. This occurs when bacteria naturally present in the mouth combine with sugar (remaining in the mouth from foods or beverages consumed) to produce acid that erodes tooth enamel. When demineralization is allowed to continue by not cleaning the teeth, it can lead to the formation of holes in the enamel. All cavities occur in this way.
Minerals such as fluoride, calcium and phosphate help to correct demineralization by strengthening weakened areas of tooth enamel. Fluoride accumulates in teeth and bones, adhering to areas where demineralization has occurred and making the enamel harder than it was before. The rebuilding of tooth enamel is called remineralization. It strengthens teeth and helps to prevent cavities, but cannot restore an area once a cavity has formed. Fluoride is also absorbed into plaque, and inhibits its growth by disrupting the acid-producing activity of bacteria in the mouth.
Fluoride directly applied to teeth, is absorbed into tooth enamel. Fluoride levels in the mouth remain high for several hours after a topical application. The use of fluoride is important because tooth decay remains a significant problem in the United States. Professionally applied fluoride treatments provide extra protection against tooth decay. These treatments are safe and effective. The fluoride used for these treatments has a higher concentration level and different chemical makeup than the fluoride found in over-the-counter products. Before a fluoride treatment, a patient's teeth will be cleaned. The fluoride varnish is then painted onto the teeth and quickly dries. The fluoride used in professionally applied treatments is flavored to make the experience more palatable for patients.

Dental sealants are a thin, composite resin coating applied to the chewing surfaces of back teeth (molars and premolars) to help prevent cavities from developing in children. While fluoride has played a large role in decreasing smooth surface decay, fluoride has its least preventive effect on the deep grooves, called pits and fissures, of the back teeth. Dental sealants have been shown to be highly effective in the prevention of pit and fissure caries/decay. Teeth with the highest priorities for sealant placement are usually the first and second permanent molars. Because of their less shallow grooves, primary or baby molars and permanent bicuspids are less susceptible to decay and therefore are at a lower priority for placement. Although the application process is fairly simple, attention to technique is very important. Inadequate isolation and subsequent contamination by water or saliva will cause the sealant to fail. The teeth to be sealed are cleaned by a rotary instrument. A mild acidic solution is then applied to the grooves and washed off after approximately twenty seconds. The teeth are then thoroughly dried. The resultant tooth surface has been etched or roughened, allowing the sealant material to adhere to this roughened surface. A thin layer of the white sealant material is painted on the tooth & cured with a curing light. Miles of Smiles, Ltd. uses a BPA-free sealant called Ultra seal XT Plus made by Ultradent Products, Inc. For continued effectiveness, the sealants should be checked regularly and replaced as needed.