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.