American dentists attacked over cost of care

Empty dental chair
US dentistry—where have all the patients gone? One in three can’t afford to come…

A report about the high cost of dental care aired on the PBS television network in the United States has been making news across the world after it revealed one in three Americans skip dental visits because they can’t afford them. The American Dental Association has  responded, saying that the program (and other media) can increase awareness of the “ongoing tragedy” of the silent epidemic of oral disease and, “we hope, the political will to do something about it.”

Dr Frank Catalanotto, a professor at the University of Florida’s College of Dentistry, told the PBS Frontline program that “1,200 children a year in Florida get their dental care under general anaesthesia in a hospital,” and that only 25 per cent of Medicaid-eligible children get any kind of dental care.

That statistic is more shocking because Medicaid only covers 10 per cent of the population.

The findings come months after it was revealed that more Americans unable to afford dental work have turned to the emergency room—a choice that often costs 10 times more than preventive care and offers far fewer treatment options than a dentist’s office.

In a statement released yesterday, the American Dental Association said, “The American Dental Association appreciates the mounting media interest in what Surgeon General David Satcher, M.D., famously called a “silent epidemic” of oral disease.  Unfortunately, the situation has improved little since Dr. Satcher wrote those words in 2000.

“We regret, however, that “Frontline” chose to title its program “Dollars and Dentists,” and devoted so much of its air time to the debate over allowing so-called “dental therapists” with as little as 18 months post-high school training to perform surgical procedures like extractions and pulpotomies (drilling through the hard tooth surface and removing soft tissue). The ADA believes therapists’ training does not adequately prepare them to do so. This is especially true for the populations in greatest need, in which many people suffer from co-morbidities like diabetes and obesity, or for children with rampant decay and the accompanying chronic infections.”

The statement also expressed concern over allegations of Medicaid fraud aired in the program, saying, “we must not let a few bad actors tarnish the work of thousands of honest, caring dentists who treat Medicaid patients, often for breakeven or even negative revenues.”

“The country will never drill, fill and extract its way to victory over untreated dental disease. A public health system based primarily on surgical intervention in disease that could have easily been prevented is ill conceived and doomed to fail. Until we shift the focus to oral health education and disease prevention, the country will fail to meet the needs of those who face the greatest barriers to good oral health,” the ADA statement said.


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