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A digital marketplace aims to give patients the freedom to take control of any decisions they make to improve and maintain their oral health. So, what does it mean for dentists? By Cameron Cooper
As someone who wanted to be a dentist from the age of eight, Dr Heath Fraser does not want to be seen as the profession’s “bad guy”.
He does want to shake things up, however. Owner and principal dentist of Avenue Dental Kawana and Fresh Breath Clinic on the Sunshine Coast in Queensland, Dr Fraser also launched AirSmile in 2019. The national comparison and booking portal for dental services is designed to offer price transparency for patients while helping dentists attract more patients.
The digital platform promises that, with just an email, patients can compare dentists and book and manage dental care. While Dr Fraser says AirSmile simply provides a service that is similar to price-comparison portals in sectors such as insurance and travel, he acknowledges that some dentists are cautious about the concept.
“There are people who don’t like it because it’s potentially a change,” he says. “But I’m not the bad guy. I’m not trying to cheapen the industry. I’m just passionate about laying our cards on the table as dental professionals.”
Australian Dental Association president and Adelaide dentist Dr Mark Hutton says price transparency is at the heart of the way the ADA advises its members to conduct their business. He notes that dentists normally provide a patient with a treatment plan, which includes the necessary treatments and item codes in the plan.
“That means patients with Extras Cover can then go to their private health insurance provider to ascertain how much out of pocket they will be, if at all, after the insurer has paid out. That system gives complete transparency for all concerned so the patient can budget, and so there are no ambiguities or errors.”
With regard to aggregator platforms such as AirSmile, Dr Hutton says that while one of the platform’s search functions seeks to compare dentists based on the prices they charge for a given service, “it does not marry up with service quality. Not all treatment decisions should be based on what the clinician charges,” he says. “At best, these sorts of platforms can only provide general views. A filling is just a filling to a member of the public, which does not mean that there is a single price point for that treatment. Patients should seek to get comparative quotes from a dentist if they’re concerned that they might be paying too much. It’s only through a proper examination and treatment planning that you can make an informed decision, so I wouldn’t recommend patients rely solely on these sites for information.”
Dr Hutton adds that a possible risk with such platforms is that fee changes may not be uploaded to the platform in real time, or recommendations could be out of date. “The ‘Reputation’ facility on the platform is also very subjective in that what may be attractive to one patient may not be relevant to another. If patients really want to find out costs, they should contact a couple of local practices which will better reflect the costs in their area, rather than a national average which might not take into consideration any local issues such as transportation of materials and equipment.”
Love of the profession
Growing up, Dr Fraser admits his eating habits caused a few trips to the dentist. Even at a young age, he appreciated how they could fix his oral issues and send him on his way. “I always loved it—the dentist would take away my pain every time.”
Today, he is proud to be part of a profession that has allowed him to pursue clinical and cosmetic dentistry, while also chasing business dreams through his practices and AirSmile. “I feel very fulfilled and proud to be a dentist,” he says. “It’s been very challenging, but extraordinarily rewarding.”
With seven chairs and about 30 staff, Dr Heath attributes the success of Avenue Dental over the past decade to creating the right culture. Respect for all. No hierarchy. Team first. Autonomy. Freedom. “We allow people space to be the best they can be,” he says. “That’s powerful and that’s why people stay with you.”
He also prides himself on treating good people well. “I have several key people who’ve been with me right from the start and they always support me. I wouldn’t have been able to achieve the growth without them.”
With rising inflation and cost-of-living pressures, Dr Fraser expects some tougher times ahead for dentists in the next couple of years as patients tighten their purse strings.
AirSmile has commissioned an independent survey of 1008 Australians to gauge whether rising living expenses are having an impact on their ability to prioritise their health, particularly their dental needs. Respondents were presented with 12 of the most common dental treatments and asked whether they would delay them for at least 12 months. Dental treatments included check-ups and cleans, major dental work and cosmetic treatments, including whitening and veneers.
The survey found that almost three in four (71 per cent) Australians plan to delay dental treatments for at least a year. Specifically, 43 per cent of respondents would put off dental check-ups and cleans, while 40 per cent would delay cosmetic dentistry such as bonding, whitening and veneers, and 32 per cent would delay teeth straightening such as braces or aligners. Just over one quarter (29 per cent) of respondents said they would not delay any dental treatments.
The results shocked Dr Fraser. While he expected some patients to opt to get a tooth removed rather than have a root canal treatment in order to save money, he did not expect them to be putting off a regular $150 appointment as part of their budget cut. The findings have strengthened his belief that AirSmile has a role to play in providing more affordable dental care and giving patients full transparency around the decisions they make and the prices they pay.
“Affordability is a problem, partly because it’s not supplemented by government. We’re seen as being expensive and that there may be an underlying element that we’re profiteering off dentistry,” he says.
While he rejects any suggestion of widespread industry profiteering, he believes that platforms such as AirSmile can help change perceptions. Just as people scope the market when buying a car or use comparison sites when purchasing health insurance, Dr Fraser is certain there is a place in dentistry for greater price transparency. “You just don’t have that option at the moment in dentistry and you should. If someone wants the cheapest dentist, they have that right.”
Dr Hutton says there is no doubt that cost-of-living pressures have long been a factor for many Australians. “We know that many people miss out on regular preventive care because they’re on low incomes, are pensioners or are unable to maintain their private health insurance premiums,” he says. “The recent and projected interest rates are likely to put even more pressure on these increases, meaning more people will either miss out on treatment or join the long public dental waiting lists which are often two or more years long.”
Dr Hutton says dentists will not be exempt from the increasing costs in materials, wages and commodities that will need to be absorbed and this may see some small increases in the cost of treatment. “However, it should be noted that ADA fee surveys demonstrate that dental fees have remained below CPI for many years. Now that there are high levels of vaccination in the community, dental practices have seen a lot of patients returning to the dentist to catch up on treatments or resume regular check-ups, but this increase in demand may not continue for a long period. The ADA is very active in increasing oral health literacy in the community and the connection between oral health and general health, so we hope that more and more individuals recognise the impact that oral health neglect can have.”
Regardless of platforms such as AirSmile, Dr Fraser says price will never be the only determinant for many patients when they choose a dentist. “In reality, many people still want the ‘friendly dentist’, or the dentist with the best reputation or reviews. These things all play a big part in the decision-making.”
No turning back
With an aligner business about to be launched as well, Dr Fraser is balancing his dental and entrepreneurial sides. “I’ve always been trying to grow and push myself. But this is my biggest leap with AirSmile.”
The growing concerns about the economy and cost-of-living challenges should lead to greater demand for AirSmile, which generates about 1000 searches a week at present. “As a start-up, it’s had huge challenges,” Dr Fraser says. “But we’re seeing good uptake from dentists and there’s a lot of searches from patients.”
His aim now is to keep growing the platform to create a “true marketplace. I’m just proud that AirSmile has progressed the industry’s conversation about price transparency,” he says. “If it’s not us or another group, or the ADA, this information will be out there. Our platform is not perfect yet by any means, but we’re listening to our patients and dentists.”