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Monthly Archive for: ‘May, 2013’

Planning a trip out of the country? It’s helpful to schedule a dental checkup before you leave, especially if you’ll be traveling in developing countries or remote areas without access to good dental care.

If you are thinking about a dental ‘vacation’ outside the United States in an attempt to save money, which is often referred to as “dental tourism,” here are some things to consider:

Education and Clinical Training of U.S. Dentists

Dentists trained in the U.S. graduate from a dental school accredited by the American Dental Association Commission on Dental Accreditation (CODA). After earning their undergraduate degree and their dental degree (eight years for most), some dentists continue their education and training to achieve certification in one of nine recognized dental specialties. In addition, dentists must pass national examinations and meet state requirements before they earn a license to practice.

Dentists are doctors specializing in oral health whose responsibilities include diagnosing oral diseases, ensuring the safe administration of anesthetics, performing oral surgical procedures and managing oral trauma. Comparable levels of training may exist in the country to which you are travelling, but this may be difficult to find out if that country does not have similar dental regulations.

Safety

The procedures, equipment and drugs used by dentists in the U.S. are held to high standards. For example, the U.S. Centers for Disease Control and Prevention (CDC) published comprehensive guidelines on infection control procedures for dental health-care settings. These guidelines exist to prevent the spread of infections, including blood borne illnesses such as hepatitis and AIDS. U.S. dentists must abide by regulations for radiation safety (X-ray equipment and its use) and for proper disposal of biomedical waste. Also, the drugs and dental instruments and materials used by dentists in the U.S. are regulated by the U.S. Food and Drug Administration to ensure that they are safe. These standards are in place for your safety and for that of dental office staff.

Travel Advisories

The U.S. Department of State issues travel alerts to disseminate information about short-term conditions, generally within a particular country, that pose imminent risks to the security of U.S. citizens. In the spring of 2009, for example, the Department of State issued a travel alert cautioning people to avoid non-essential travel to Mexico because of an outbreak of H1N1 influenza in that country that resulted in a number of deaths. In addition, the alert recommended that travelers check the department’s Web site for new travel advisories as well as the Web site of the U.S. Centers for Disease Control and Prevention for any additional information or recommendations.

Insurance, Privacy and Dental Records

If you have dental insurance for dental care performed outside of the U.S., you should confirm with your insurer and/or employer that follow-up treatment is covered upon your return to the U.S. You should consider arranging follow-up care with a U.S. dentist prior to travel to ensure continuity of care upon your return. If you do not have a dentist in the U.S., you can find an ADA member dentist in your area.

In addition, you should confirm with your U.S. dentist and the dental care provider in the other country that the transfer of patient records to-and-from facilities outside of the U.S. is consistent with current U.S. privacy and security guidelines.

Flight and Vacation Activities After Certain Dental Procedures

It’s important to know that many dental procedures are surgical in nature. Dental implants, for example, often require months of healing. Post treatment risks after dental surgical procedures include bleeding, pain, swelling and infection. Your body may need time to rest and recover after procedures such as wisdom tooth extraction, root canals, dental implants and gum surgery, which should be factored in to flight and vacation activity schedules. In addition, it is possible that changes in airplane cabin pressure might cause discomfort in some patients who have recently had oral surgery. Bear in mind that significant dental procedures require follow-up care to make sure everything is healing and functioning properly. Continuity of care is important and should be a consideration when making treatment decisions.

Continuity of Care

The American Dental Association (ADA) encourages you to visit a dentist on an ongoing basis to ensure continuity of care. Establishing a “dental home” provides you with comprehensive oral health care so conditions such as gum disease and tooth decay can be diagnosed at an early stage when treatment is simpler and more affordable. A dentist who knows your case history can provide you with guidance on good oral health care habits, preventive oral health services and diagnosis and treatment of dental disease based on your individual needs. One dental visit does not establish the continuity of care that is necessary for maintaining good oral health.

Questions and Considerations Prior to a Dental Vacation

  • How will you determine the qualifications and experience of the dentist who will be treating you in a foreign country?
  • How is payment processed?
  • If you have dental insurance, will the benefits cover treatment that is performed outside the United States and if so, to what extent?
  • What happens if something goes wrong during or after treatment? Would you need to return to the country where you received treatment? Can you afford that?
  • If you need corrective care after you return, will that be covered by your dental insurance or will you have to pay out of pocket for another dentist to provide corrective care?
  • If something goes wrong after receiving dental care in another country, what are your legal rights?

Memorial Day History

Three years after the Civil War ended, on May 5, 1868, the head of an organization of Union veterans — the Grand Army of the Republic (GAR) — established Decoration Day as a time for the nation to decorate the graves of the war dead with flowers. Maj. Gen. John A. Logan declared that Decoration Day should be observed on May 30. It is believed that date was chosen because flowers would be in bloom all over the country.

The first large observance was held that year at Arlington National Cemetery, across the Potomac River from Washington, D.C.

The ceremonies centered around the mourning-draped veranda of the Arlington mansion, once the home of Gen. Robert E. Lee. Various Washington officials, including Gen. and Mrs. Ulysses S. Grant, presided over the ceremonies. After speeches, children from the Soldiers’ and Sailors’ Orphan Home and members of the GAR made their way through the cemetery, strewing flowers on both Union and Confederate graves, reciting prayers and singing hymns.

Local Observances Claim To Be First Local springtime tributes to the Civil War dead already had been held in various places. One of the first occurred in Columbus, Miss., April 25, 1866, when a group of women visited a cemetery to decorate the graves of Confederate soldiers who had fallen in battle at Shiloh. Nearby were the graves of Union soldiers, neglected because they were the enemy. Disturbed at the sight of the bare graves, the women placed some of their flowers on those graves, as well.

Today, cities in the North and the South claim to be the birthplace of Memorial Day in 1866. Both Macon and Columbus, Ga., claim the title, as well as Richmond, Va. The village of Boalsburg, Pa., claims it began there two years earlier. A stone in a Carbondale, Ill., cemetery carries the statement that the first Decoration Day ceremony took place there on April 29, 1866. Carbondale was the wartime home of Gen. Logan. Approximately 25 places have been named in connection with the origin of Memorial Day, many of them in the South where most of the war dead were buried.

Official Birthplace Declared In 1966, Congress and President Lyndon Johnson declared Waterloo, N.Y., the “birthplace” of Memorial Day. There, a ceremony on May 5, 1866, honored local veterans who had fought in the Civil War. Businesses closed and residents flew flags at half-staff. Supporters of Waterloo’s claim say earlier observances in other places were either informal, not community-wide or one-time events.

By the end of the 19th century, Memorial Day ceremonies were being held on May 30 throughout the nation. State legislatures passed proclamations designating the day, and the Army and Navy adopted regulations for proper observance at their facilities.

It was not until after World War I, however, that the day was expanded to honor those who have died in all American wars. In 1971, Memorial Day was declared a national holiday by an act of Congress, though it is still often called Decoration Day. It was then also placed on the last Monday in May, as were some other federal holidays.

Some States Have Confederate Observances Many Southern states also have their own days for honoring the Confederate dead. Mississippi celebrates Confederate Memorial Day on the last Monday of April, Alabama on the fourth Monday of April, and Georgia on April 26. North and South Carolina observe it on May 10, Louisiana on June 3 and Tennessee calls that date Confederate Decoration Day. Texas celebrates Confederate Heroes Day January 19 and Virginia calls the last Monday in May Confederate Memorial Day.

Gen. Logan’s order for his posts to decorate graves in 1868 “with the choicest flowers of springtime” urged: “We should guard their graves with sacred vigilance. … Let pleasant paths invite the coming and going of reverent visitors and fond mourners. Let no neglect, no ravages of time, testify to the present or to the coming generations that we have forgotten as a people the cost of a free and undivided republic.”

The crowd attending the first Memorial Day ceremony at Arlington National Cemetery was approximately the same size as those that attend today’s observance, about 5,000 people. Then, as now, small American flags were placed on each grave — a tradition followed at many national cemeteries today. In recent years, the custom has grown in many families to decorate the graves of all departed loved ones.

The origins of special services to honor those who die in war can be found in antiquity. The Athenian leader Pericles offered a tribute to the fallen heroes of the Peloponnesian War over 24 centuries ago that could be applied today to the 1.1 million Americans who have died in the nation’s wars: “Not only are they commemorated by columns and inscriptions, but there dwells also an unwritten memorial of them, graven not on stone but in the hearts of men.”

To ensure the sacrifices of America ’s fallen heroes are never forgotten, in December 2000, the U.S. Congress passed and the president signed into law “The National Moment of Remembrance Act,” P.L. 106-579, creating the White House Commission on the National Moment of Remembrance. The commission’s charter is to “encourage the people of the United States to give something back to their country, which provides them so much freedom and opportunity” by encouraging and coordinating commemorations in the United States of Memorial Day and the National Moment of Remembrance.

The National Moment of Remembrance encourages all Americans to pause wherever they are at 3 p.m. local time on Memorial Day for a minute of silence to remember and honor those who have died in service to the nation. As Moment of Remembrance founder Carmella LaSpada states: “It’s a way we can all help put the memorial back in Memorial Day.”