Oct. 7 - Are power tooth brushes better?
Oct. 28 - Brewster Hospital special levy election

ARE POWER TOOTH BRUSHES
BETTER THAN MANUAL?

LEAD-IN: If you're discouraged by the way your 401-K is looking these days, take heart. You've undoubtedly been making a regular, very small investment that is paying off big time. The investment? Your toothbrush. To tell you more, here's Mary Koch with "Your Health Care Dollar:"

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Any dentist will tell you that regular tooth-brushing can pay off by saving you hundreds, even thousands of dollars worth of dental repair down the road. Not to mention pain and suffering. And we have the Chinese to thank for it.

The American Dental Association traces the history of toothbrushes to 1498, when the Emperor of China embedded hog bristles in a bone handle. The idea spread to Europe, where people had been using twigs made of sweet-smelling wood to clean their teeth. Sounds like the precursor of the mint-flavored tooth pick.

The hog bristle toothbrush had some drawbacks. Hog bristles were expensive. Poor people could not afford individual toothbrushes. Families would save money by sharing the same toothbrush. By today's standards, that's a little more intimate than we want to be.

It wasn't until the 1920s before American dentists were recommending that adults and children each use their own toothbrush to clean after meals. And in 1938 the Dupont company introduced nylon bristles, replacing pig bristles.

The next big innovation was the electric toothbrush, followed by the battery-powered brush. Several well-known manufacturers, including Gillette and Proctor and Gamble, are selling battery-powered toothbrushes for under ten dollars. Proctor and Gamble has teamed up with the Crest toothpaste company to make a brush that both pulsates and oscillates. P and G claims that its new model will make manual brushes virtually obsolete.

Not so fast, says the American Dental Association. The ADA says manual toothbrushes can be just as effective as the powered ones – as long as they're used correctly.

The brush makers cite clinical studies that show power brushes remove more plaque than manual brushing. Problem is, the studies are usually paid for by the brush makers themselves.

For example, Braun Oral B gave dentists powered toothbrushes to be passed on to patients. The dentists were asked to subjectively monitor the patients' brushing habits and oral health. More than 16 thousand patients got freebie power brushes. The dentists reported a positive effect on the oral health of more than 80 percent of the patients. Most of the patients themselves reported their oral health was somewhat better or much better after using the powered toothbrush.

The Dental Association does agree that people with motor skill impairments, such as arthritis, can benefit from the powered toothbrushes. And parents report that their kids enjoy the battery brushes, which makes it more likely they'll develop good tooth-brushing habits.

So the Dental Association comes down with a firm maybe on the issue of powered versus manual brushes. The ADA suggests you talk to your own dentist or oral hygienist about which toothbrush to use and how to use it.

The ADA does say toothbrushes should be replaced every three to four months or sooner if the bristles become frayed. Toothbrushes with frayed bristles may actually harm gums and generally do not clean teeth effectively.

However, you don't have to worry about changing your toothbrush if you are recovering from a cold or other infectious disease. The ADA says almost all tooth pastes contain detergents to kill germs that may linger on the toothbrush between brushings.

The American Dental Association does have standards for toothbrush effectiveness, packaging and labeling. If you see the ADA Seal of Acceptance you know claims on the package can be scientifically supported.

So, take a good look at your toothbrush. If it's due for replacement, go ahead. Invest. These days, it may be a better place to put your money than the stock market. I'm Mary Koch and that's "Your Health Care Dollar" for this week.

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BREWSTER HOSPITAL LEVY ELECTION:
A SIGN OF THE TIMES FOR RURAL HOSPITALS

LEAD-IN: Voters in the Okanogan-Douglas Hospital District will decide on election day whether to increase property taxes to help out the hospital in Brewster. The special levy proposition is a symptom of financial problems facing many rural hospitals. Mary Koch has more with "Your Health Care Dollar:

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MARY: The Okanogan-Douglas Hospital district is asking voters to lift the one percent limit on property taxes, adding about 27 cents to the tax bill for every thousand dollars worth of property. In previous years, the district has asked for special levies to buy specific items, such as CAT scan equipment or an intensive care unit. But hospital administrator Martin Nolan says money from this levy is necessary just to keep the hospital running.

NOLAN: (19) It could be used for anything. It could be used for employee salaries, purchase of equipment, anything that's day-to-day operation of the hospital.

MARY: Basically what voters are being asked to do is fill a gap created by reduction of federal payments to hospitals. Nolan says the hospital in Brewster has a high percentage of Medicare, Medicaid and indigent patients. In recent years that has meant an increased financial burden.

NOLAN: (24) Because our reimbursements from Medicare/Medicaid have dropped so significantly over the last few years, that has brought our revenue into the hospital down, which doesn't give us a lot. As a matter of fact, we've been at a loss for three years. This would help us significantly to continue to operate.

MARY: The Okanogan-Douglas County Hospital District faces another challenge too. It covers a huge geographical area.

NOLAN: (36) Our district runs all the way up to Mazama. You've got Twisp and Winthrop, all the way down to Pateros, the whole Methow Valley there, Pateros over to Mansfield, then across to Bridgeport and right around to where the town of Monse is.

MARY: School districts in this large area don't always succeed in their efforts to pass special levies. But Nolan sees a difference in the way voters look at health care issues. He points out that Brewster's ambulance levy, which was on the ballot earlier this fall, passed unanimously.

NOLAN: (70) I think that people realize that health care is something that needs to be here. I mean, the emergency room at the hospital needs to be here. Many people would not make it to the next town, to Wenatchee or Spokane if this emergency room was not here. It's much similar to the ambulance levy passing.

MARY: Emergency care may be primary in motivating voters, but Nolan notes that having other local hospital services is also significant.

NOLAN: (110) I would say that when you're talking about why a levy would or would not pass, I would say that the emergency room should be a number one on people's list, is my mother or father going to make it if they're having a heart attack. It's a very necessary thing to have an emergency room here. The other factors for us are that we've been able to maintain major and minor surgeries. a lot of outpatient services where people may have to travel just to get something as simple as a lab test or an x-ray. We have provided that service, mammograms, we even have a really nice CAT scan here. That prevents people having to drive to those other areas to get that service down, and we have excellent staff here to provide that for them.

MARY: Earlier this year, the Washington State Hospital Association issued a report predicting that the economic recession will impact rural communities more severely than most urban areas of the state. According to Nolan, that prediction is right on target.

NOLAN: (143) The fact is that all rural hospitals, not just ours, if anybody wants to look around to our neighbors, they're all, we're all struggling, and it's a tough go.

MARY: I've been talking with Martin Nolan, administrator for the Okanogan-Douglas Hospital in Brewster. This is Mary Koch and that's "Your Health Care Dollar" for this week.

Election Date: Nov. 5, 2002
Levy Proposal: Increase from 7.65 cents to 34 cents per $1,000 assessd property