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Time for dental reform? - Brattleboro Reformer

Time for dental reform? By RICHARD DAVIS

Wednesday April 7, 2010 Why is it that when there is public discussion about health care teeth and gums rarely get mentioned? Why is it that the dental profession has had so little public scrutiny and so little relative intrusion from government other than quality control issues relating to products, procedures and licensing? Maybe the tea-baggers should hold up the dental profession as their ideal model for the delivery of U. S. health care. It is a profession that is dominated by the private sector business model with a smattering of public funds used for dental care. Dentists charge whatever the marketplace can bear and people who have the best dental care generally have the most money. We have come a long way from the itinerant tooth pullers who provided the only dental care available. Dental technology has improved the lives of many Americans and it is now possible to have the most beautiful disease-free smile that money can buy. Fillings, root canals, crowns and bridges have gone high-tech along with digital, low radiation x-rays. The progress has been astounding, but so have the price increases. I'm not looking to blame anyone for the poor access to timely dental care that is the fate of too many Americans. Dentists invest a lot of time and money in education and in setting up a business and they deserve to be justly compensated for their efforts. But our society needs to find a way to improve access to all of the treatments now available.

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The burden of improving access should not fall on dentists but on government. That is, if you believe that government should play a role in providing basic health services to the people it serves. Dental insurance helps some people, but most policies are out of financial reach for many and I suspect that the majority of people who do have dental policies have some of the premiums paid by their employers. Then there is the Medicaid problem. In Vermont, Medicaid recipients get a whopping $400 a year to spend on dental care. When dentists serve Medicaid patients, the reimbursement is so low that they usually lose money. As far as I know, there is only one dentist in Brattleboro who will see Medicaid patients. Somehow, he must have the lowest overhead in town because no other dentist seems to be able to absorb the financial Medicaid hit. According to a March 11 USA Today story, "Results out this week from a Gallup-Healthways poll of 355,334 Americans indicate that more than onethird of the population, 34 percent to be exact, did not visit a dentist last year at all. A recent American Dental Association (ADA) survey shows dentists' incomes are dropping, too, and some dentists say patients who've lost dental insurance are asking about alternate payment plans or skipping appointments. "The 2008 Gallup data report that in nine states, close to half of residents did not visit a dentist last year, even though the ADA recommends twice-yearly cleanings and check-ups. Men, African Americans, Hispanics and seniors were more likely to skip, an historic pattern. Over half of those making less than $2,000 a month reported omitting visits as well, according to Gallup. For people with tightening budgets, other expenses come first... ĘťI didn't go to the dentist last year at all,' says Peggy Jones, of Charleston, S.C. Self-employed, Jones says ponying


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Time for dental reform? - Brattleboro Reformer

up for the mortgage, household bills and other medical needs comes first."

4/13/10 11:48 AM .

In the March Gallup poll, 72 percent of Vermonters said that they visited a dentist within the last 12 months, making the state eighth-best in the nation. If 28 percent of state residents said that they did not have health care, we would declare a crisis, but when it comes to dental health such a high figure puts us in the company of some of the best covered Americans. It is one of our great underreported national disgraces along with our abysmal record in infant mortality and pre-natal care. We need to let our politicians know that dental care is important, but not affordable for too many Vermonters. Many with dental coverage, such as kids covered by Dr. Dynasaur, find there are still huge obstacles to getting dental care because many dentists do not accept Medicaid. I am working with an organization on a project to bring this issue to the attention of Vermont legislators, while presenting possible solutions. We need to hear from anyone who has had issues with access or affordability of dental care. Have you gone without needed care because you couldn't afford it? Have your kids gone without dental care because you couldn't find a local dentist who would take Dr. Dynasaur? Do you have Medicaid but can't find a dentist who will accept you as a new patient? E-mail your story to me at or call me at 802-251-0915. I will keep your information confidential and will only share it with your permission. Richard Davis is a registered nurse and executive director of Vermont Citizens Campaign for Health. He writes from Guilford and welcomes comments at Advertisement

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