Tuesday, February 10, 2009

Dentists Neglect Poor Kids 364 Days a Year

Most dentists neglect low-income Americans all year, except for one “Give-Kids-A-Smile” day, filled with media events, feel-good stories,corporate sponsorship, costly T-shirts, but little drilling and filling. When the media spotlight goes out, so do the dentists. At the same time, organized dentistry fights hard against any viable group willing to alleviate the US dental health epidemic year-round.

Theoretically, government sponsored dental care, under Medicaid, is free for children living in poverty. Sadly, “nationally, only about 10% of all dentists accept Medicaid patients,” according to a report by the Children’s Defense Fund. And over 108 million Americans lack dental insurance, according to the American Dental Association (ADA).

According to American Family Physician, more than three out of four dentists do not treat the uninsured.

Dentists’ income is derived mostly from private insurance and patient’s pockets, says the ADA. Dentists aren’t hurting. Rated among the highest-paying jobs by, the top ten money-making cities for dentists range from Charlotte ($195,540) to Omaha ($176,830).

Meanwhile, 6.5 million children aged 2 through 18 in Medicaid have untreated tooth decay, according to the Government Accounting Office, often forcing them to get expensive hospital emergency care when the decay spreads, the pain is unbearable, costing the taxpayers thousands of dollars to treat. Some have died from untreated tooth decay.

The logical solution is to require dentists to treat more low-income Americans – either for free, for what Medicaid offers, or on a sliding scale. But dentists don't like mandates – well for themselves anyway. They do like fluoridation mandates, though. Dentists prefer to treat the water rather than the individual.

Dentists didn’t make it on their own. Government subsidizes dental tuition and dental schools and regulates their licenses. Dentists need to give back or allow other viable groups to fill the void.

Dental Health Aide Therapists are currently repairing and pulling teeth in rural Alaska where no dentist would live or work. The American Dental Association and the Alaska Dental Society spent $1 million on a lawsuit trying unsuccessfully to stop them.

Organized dentistry now lobbies against solo-practicing dental hygienists, denturists (false teeth makers) from working directly with the public and Dental Therapists in any other state.

Organized dentistry uses its credentials, political clout and deep pockets filled up with corporate cash to lobby our legislators to pass laws that benefit themselves while an oral health epidemic occurs on their watch. See:

Unfortunately, organized dentistry uses GKAS day to convince legislators to give them more money to treat Medicaid patients and to promote water fluoridation - a tax-wasting scientfically failed method of reducing tooth decay.

Although the District of Columbia is 100% fluoridated and has the nation’s highest density of dentists, 44% of children in a typical elementary school have cavities in primary teeth – 34% is unfilled. Just 30 dentists (2.5 percent) are Medicaid billing dentists with at least one paid claim, according to “Issue Brief: Oral Health Is Critical to the School Readiness of Children in Washington, DC.”

The Raleigh News & Observer reports, that the ability of patients to pay and the lack of dentists have negatively affected access to dental care and the problem likely will get worse in North Carolina, which is 88% fluoridated About 200 emergency department dental cases occur daily throughout the state, they report.

“Nearly half of [60% fluoridated] Massachusetts children experience tooth decay before third grade…’We struggled over the last several years, particularly in part of the district I represent, which is Cape Cod, to even get any dentists to accept Medicaid patients,’" reports the State House News Service on February 2000.

Rochester, NY, is fluoridated: "Hundreds of local children are ending up in the operation room because of cavities that could have been prevented...The Eastman Dental Center sees more than 300 of these kinds of cases a year. In [fluoridated] Buffalo, 700 plus cases, and thousands state wide [NYS is 73% fluoridated],” according to NBC News

Although Kentucky is 99.8% fluoridated, “Last year, four area hospitals had 1,500 visits from patients seeking help with tooth pain…About a third of those cases involved children and teens, reported the Messenger-Inquirer on March 8, 2008 .

“State officials have found that 4,500 Kentucky 3-year-olds have dental pain each day, McKee said. Nearly half of preschoolers have untreated tooth decay,” they report.

Minnesota is 98% fluoridated: "Last year, there were 22,000 emergency-room visits for dental problems." reported the Star Tribune on January 22, 2009.

In West Virginia, 92% fluoridated, "It's especially difficult to find an oral surgeon who accepts Medicaid patients in Southern West Virginia where dental health problems are rampant,” reports the Charleston Gazette on January 11, 2009.

New York State Department of Health statistics illustrate fluoridation’s inability to equalize cavity rates between low and high socio-economic-status groups, and that fluoridation and tooth decay rates are not inversely related See chart:

Connecticut mandates fluoridation. Yet 48% of 4-year-olds suffer
untreated cavities partially because 85% of dentists won’t or can’t treat
patients with low-paying government-sponsored insurance, according to Elements of effective action to improve oral health & access to dental care for Connecticut’s children & families.

More evidence of dental needs despite fluoridation

What is needed is to train Dental Therapists in this country. The ones working in Alaska were trained for two or three years in New Zealand. They drill, fill and pull teeth as effectively as dentists and have been working for decades in developed countries. As a result, children in New Zealand have no unfilled cavities because they are seen in school by Dental Therapists every year and rural Alaskans aren't pulling their own teeth. Organized dentistry is at odds with public health dentists on this. The former doesn't like any groups infringing upon its lucrative monopoly - even if it means Americans must suffer from dental neglect 364 days a year.


denturist said...

Good points Sally. It is sure nice to see others coming out against the American Dental Association as they polish their public image to manipulate state legislators into doing things, "corporate ADA's ways." Why doesn't the American Dental Association stop the corporate waste and take steps to spend money in more productive ways instead of big fancy buildings, flamboyant meetings and Federal monies for research that educates the dentist for a better bottom line that fills their pockets while dentistry gets more expensive and out of range for the average American.

Wasn’t it the Food and Drug Administration that originally come out with the warnings on fluoride and our babies? The ADA jumped on board after FDA announced it. This reminds me of the dental crown and bridge outsourcing supported by the American Dental Association and then after the NADL National Association of Dental Laboratories report to the FDA regarding lead and other poisonous metals in our dental crown and bridge coming back from overseas, the American Dental Association takes credit for reporting it to the Food and Drug Administration. ADA should have credited NADL for taking a stand not ADA. ADA continues to give us the ADA corporate greed stamp of approval like they did and continue to do with fluoride. Here in the United States, the American Dental Association continues to fight, the denturist, dental health aide therapist, and independent dental hygienist.

We need independent practices and more college programs for dental hygienists. Independent practice for hygienists will free-up hygienists for more public health services and the freedom to establish fees without the dentist overhead. There should be one or more dental hygienists in every public health clinic. Dental hygienists should have their own boards, independent of the dental boards. Thank you for your consideration--- Gary W. Vollan L.D.

Anonymous said...

Oh what and you're going to blame the dentists for "neglecting" these kids? Are you kidding me? It's their loser parents who aren't educated enough to get a decent job and pay for dental insurance. It's not the ultimate responsibilty of dentists to take care of people's kids, even if they are poor: it's the responsibility of the parents. If they knew they couldn't afford proper dental hygiene for their kids, why did they have them in the first place? And further more, dentists are paid a lot of money, but there's a good reason for that: they work for it! Do you have any idea how much dental school costs and how many years of school someone has to complete to become a dentist? Probably not, or you wouldn't be bashing the dental community

dentist in southern california said...

You have a nice blog,this reminds me of the dental crown and bridge outsourcing supported by the American Dental Association,thank you so much for sharing this very important matters.

by: florence

dentist merrillville said...

There are many dentists that give back as much as possible. In the same sense, we all need to provide of your families and employees and this means having a business. Giving back once a year is better than nothing at all. Great post. Very thought provoking. dentist in merrillville