Is the NY Times hellbent on destroying the dental profession?

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By painting us a incompetent, money-grubbing, quacks, you know, the way the public has seen us since dentistry started. :laugh:

I'm a quack... but the good kind. :)

Seriously though, most people think of dentists that way.
 
More times than not, it is procrastination - not a lack of "dental insurance" or money - which keeps people away from dental offices. Everyone has money at any given time. They just allocate it differently.

On a separate note (at the risk of starting a tsunami here), I really think this is just a good piece of journalism.
When will our professionals willingly admit to all the shortcomings and disparities in healthcare access in general and dental care in specific that we as a organized body contribute to ? The way I see it, the shortage in providers is much less dramatic than it appears. The problem lies in our distribution, and not as much in the numbers. The statistics brought forth by this article and elsewhere (when accurate) are shocking, alarming and more than anything VERY TRUE !
My point is, if we don't take care of it, the media will.

Last thought here ... most people (ie; the media) blame poor oral health on a lack of insurance coverage. THERE IS NO SUCH THING AS DENTAL INSURANCE ! There are such things as fluoride, sealants and x-rays. It we be good if you would also brush and floss, stop drinking mountain dew and how about a $75 checkup every time you rotate your tires ?

-End rant.
 
This article addresses the pervasiveness of lack of dental care. It speaks nothing of dentists other than we don't like to work in poorer parts of the country. It doesn't paint dentists as money-hungry or anything of the sort.

It mentioned once that $400 bootleg dentures are made and sold by unlicenced makers to replace $1200 dentures sold by licenced dentists. However, this was not mentioned in the context that dentists overcharge. Bootlegs made by non-dentists cost less. Big surprise. In fact, there was no reference to overcharging in the entire article. The author never expressed the opinion that dentists overcharge.

The main purpose of this article was to educate people on the extent of Kentucky' dental problems. How poverty in the state and how neglect to seek dental care has taken its toll. It has an effect of teaching people to seek professional dental experts when they need it. This article supports dentistry and dentists in general. It does not come close to destroying dentistry.
 
I agree that its a good article, and that it tries to raise awareness about seeking necessary dental care. Unfortunately though, dental care is still very expensive in many areas and has become a luxury to those who can afford it.
I have met greedy dentists, as well as many self-less dentists. After working in their dental offices though, it isn't just about the dentists--its about the insurance companies, the whole business of dentistry.
In every Lucrative profession, there are those who are in it only for the money. Its just too bad that the greedy ones have come to represent the dental profession. Hopefully dental care will be more accessible to everyone in the future, and that the new generation (our generation) of dentists will help to make it happen.
 
I agree that its a good article, and that it tries to raise awareness about seeking necessary dental care. Unfortunately though, dental care is still very expensive in many areas and has become a luxury to those who can afford it.
I have met greedy dentists, as well as many self-less dentists. After working in their dental offices though, it isn't just about the dentists--its about the insurance companies, the whole business of dentistry.
In every Lucrative profession, there are those who are in it only for the money. Its just too bad that the greedy ones have come to represent the dental profession. Hopefully dental care will be more accessible to everyone in the future, and that the new generation (our generation) of dentists will help to make it happen.

Too many questions exist in the field once you decide to practice, and I've never gotten a handle on how to balance everything. 1) If you decide on working for the underserved, you'll likely live in a poorer town and give up certain luxuries in life. 2) If you charge less for dental care (below market price), too many people'll come to you and your schedule'll be overbooked. Increase the price some, and get fewer patients but enough to operate a successful clinic. (ie, where on the supply/demand curve do you operate?) 3) Do you put forth much effort to make your product 100% perfect and serve fewer patients? Or do you stop at 80% for a practically functional product, make more of it, and serve more patients?
 
More times than not, it is procrastination - not a lack of "dental insurance" or money - which keeps people away from dental offices. Everyone has money at any given time. They just allocate it differently.

On a separate note (at the risk of starting a tsunami here), I really think this is just a good piece of journalism.
When will our professionals willingly admit to all the shortcomings and disparities in healthcare access in general and dental care in specific that we as a organized body contribute to ? The way I see it, the shortage in providers is much less dramatic than it appears. The problem lies in our distribution, and not as much in the numbers. The statistics brought forth by this article and elsewhere (when accurate) are shocking, alarming and more than anything VERY TRUE !
My point is, if we don't take care of it, the media will.

Last thought here ... most people (ie; the media) blame poor oral health on a lack of insurance coverage. THERE IS NO SUCH THING AS DENTAL INSURANCE ! There are such things as fluoride, sealants and x-rays. It we be good if you would also brush and floss, stop drinking mountain dew and how about a $75 checkup every time you rotate your tires ?

-End rant.

If dentists worked Fridays, the country's supply of dentists just "increased" by 25%!!!! :eek: Midwestern's opening increased the supply by like 1%
 

I'm assuming he means dental "insurance" in a slightly different meaning of the word insurance, like insurance as in an assurance. If not...I'm not sure how he got to become a 3rd year at our school without learning about dental insurance.
 
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There doesn't really seem to be anything in here that's too disparaging to dentists, besides the "Dentists are too expensive" mantra.

Actually, you have to put your non-dentist laymen cap and re-read the article. This article was published in my home-town paper (from AP) and read completely different from the one in the Ny Times. The article is very subtlety damaging in two ways:

1. It paints a picture that people are OK with illegal dentistry because it's cheaper and serves a very important need.

2. It paints a picture that denturists are great people and should be federally legalized.

Continued scope of practice from people who are not dentists (i.e. hygienists, denturists, lab techs, illegal dentists, assistants) is a serious problem in the dental profession that EVERY dentist needs to get behind and reject the sentiment. Be wary of public pressure to license international dentists without further training. Be VERY wary of public pressure to expand the scope of dental hygiene to a "practitioner" status. "Access to care" is always the rationale of expanding scope of practice (i.e. nurse practitioners)... then you find out that you now have independent hygiene practitioners doing fillings in a place like Key West because it's considered "rural" or set up in your local shopping mall because they are "serving a very important need" of whitening your teeth in between shopping at macy's and bloomingdales.

I find the NY Times to be the finest journalism (writing style) in the world, however, it always has this leftist, conspiracy theory focused style. This constant rhetoric seeps into the public belief system subconscious... believe it.

What I find apalling about journalists who aim their articles in this fashion don't actually pull information from many sources including state dental associations. People forget to realize that a great majority of the population has access to OK dental care, with a stability focused direction, they just need to find it. Speaking with local dental associations will lead you to what's available for low-income people in each county/state.

I work 2 days a week at a health clinic in the FL Keys. Monroe County (FL Keys) is considered a RURAL county and has implemented a rural health clinic servicing the dental/medical needs of its neediest population WITHOUT dental insurance. The clinic is a CASH only business and charges based upon the patients ability to pay. You want a filling? It'll cost only between $10-50. Extraction? At a maximum $60. Dentures - between $200 - 700.

Journalists fail to look at clinics like these, dental schools, and hospital programs to serve the needs of people. They tend to have this myoptic view that you should have a dental clinic on the corner of your street that does GREAT dentistry CHEAP because people "need teeth to smile." Do some of our patients wait 3 months? Yup. Do some of them have to drive 50 miles to see us for a 30 minute appointment? Yup. Do they complain? Rarely... but a majority of the time they are very thankful. I always try to fulfill their request of getting as much done in 30-45 minutes as possible because I know I wouldn't want to make that drive too often!

Always look beyond the print... I just wish the average person would not believe everything they are told just because "the NY Times said so".

-Mike
 
Actually, you have to put your non-dentist laymen cap and re-read the article. This article was published in my home-town paper (from AP) and read completely different from the one in the Ny Times. The article is very subtlety damaging in two ways:

1. It paints a picture that people are OK with illegal dentistry because it's cheaper and serves a very important need.

2. It paints a picture that denturists are great people and should be federally legalized.

Continued scope of practice from people who are not dentists (i.e. hygienists, denturists, lab techs, illegal dentists, assistants) is a serious problem in the dental profession that EVERY dentist needs to get behind and reject the sentiment. Be wary of public pressure to license international dentists without further training. Be VERY wary of public pressure to expand the scope of dental hygiene to a "practitioner" status. "Access to care" is always the rationale of expanding scope of practice (i.e. nurse practitioners)... then you find out that you now have independent hygiene practitioners doing fillings in a place like Key West because it's considered "rural" or set up in your local shopping mall because they are "serving a very important need" of whitening your teeth in between shopping at macy's and bloomingdales.

I find the NY Times to be the finest journalism (writing style) in the world, however, it always has this leftist, conspiracy theory focused style. This constant rhetoric seeps into the public belief system subconscious... believe it.

What I find apalling about journalists who aim their articles in this fashion don't actually pull information from many sources including state dental associations. People forget to realize that a great majority of the population has access to OK dental care, with a stability focused direction, they just need to find it. Speaking with local dental associations will lead you to what's available for low-income people in each county/state.

I work 2 days a week at a health clinic in the FL Keys. Monroe County (FL Keys) is considered a RURAL county and has implemented a rural health clinic servicing the dental/medical needs of its neediest population WITHOUT dental insurance. The clinic is a CASH only business and charges based upon the patients ability to pay. You want a filling? It'll cost only between $10-50. Extraction? At a maximum $60. Dentures - between $200 - 700.

Journalists fail to look at clinics like these, dental schools, and hospital programs to serve the needs of people. They tend to have this myoptic view that you should have a dental clinic on the corner of your street that does GREAT dentistry CHEAP because people "need teeth to smile." Do some of our patients wait 3 months? Yup. Do some of them have to drive 50 miles to see us for a 30 minute appointment? Yup. Do they complain? Rarely... but a majority of the time they are very thankful. I always try to fulfill their request of getting as much done in 30-45 minutes as possible because I know I wouldn't want to make that drive too often!

Always look beyond the print... I just wish the average person would not believe everything they are told just because "the NY Times said so".

-Mike


This is right on. We are also talking about a demographic that places priority in their pack a day/ six pack a day habits over dental care. If you are spending 1500- $2000 a year on an uneccessary habit, I cant validate the complaint that the exam and fillings at the dental school for $200 is too expensive. The dental conditions of many of the kids in this demographic is exacerbated by pure negligence and laziness. Putting your 2-year-old to bed with a bottle of grape juice to keep them quiet is not a good idea. Sure, there may be some true ignorance/lack of knowledge, but I would bet there is more laziness.
 
I'm inclined to believe there's more ignorance/lack of knowledge out there than anyone would believe. This is, in many cases, a function OF and exacerbated by laziness, but in many areas and for many people ignorance of the fact that good dentistry IS accessible and necessary is the problem. So maybe dentistry needs to be more proactive in force-feeding education and demanding compliance. Maybe we need to work to eliminate the "poverty mentality" of rural areas. In any case, dentistry does need to lead the charge towards change if we want to maintain control over our own profession. Because if we don't, somebody else will.
 

I'm assuming he means dental "insurance" in a slightly different meaning of the word insurance, like insurance as in an assurance. If not...I'm not sure how he got to become a 3rd year at our school without learning about dental insurance.


Allow me to elaborate. There is no such thing as Dental insurance, but rather Dental benefit plans, Dental pre-payment or third party plans.


"... Dental benefit plans are not insurance plans but are prepayment plans. The concept and the mind-set of insurance—a benefit to be used infrequently—must be abandoned in dental benefit plans."

"... Unlike medical disease, oral disease is not an insurable risk; it does not have the essential characteristics of an insurable risk. Certain conditions are needed for a risk to be insurable2(pp257–9, 292),3:

– its occurrence should be uncertain, fairly rare and random;
– the consequences should be irreversible and not disappear spontaneously;
– the financial consequences of the risk occurring should be significant and almost catastrophic for most people;
– the affected person should have no control over the timing of the event or its consequences.

Medical diseases have all of the characteristics of an insurable risk. They are "unpostponable, unpredictable and unbudgetable." "

"... Because of these differences, it is not logical that dental benefit plans be designed or operated like medical insurance plans."


[FONT=Arial,Helvetica,sans-serif][SIZE=-1] J Am Dent Assoc, Vol 137, No 6, 801-806.[/SIZE].

.
 
Allow me to elaborate. There is no such thing as Dental insurance, but rather Dental benefit plans, Dental pre-payment or third party plans.


"... Dental benefit plans are not insurance plans but are prepayment plans. The concept and the mind-set of insurance—a benefit to be used infrequently—must be abandoned in dental benefit plans."

"... Unlike medical disease, oral disease is not an insurable risk; it does not have the essential characteristics of an insurable risk. Certain conditions are needed for a risk to be insurable2(pp257–9, 292),3:

– its occurrence should be uncertain, fairly rare and random;
– the consequences should be irreversible and not disappear spontaneously;
– the financial consequences of the risk occurring should be significant and almost catastrophic for most people;
– the affected person should have no control over the timing of the event or its consequences.

Medical diseases have all of the characteristics of an insurable risk. They are "unpostponable, unpredictable and unbudgetable." "

"... Because of these differences, it is not logical that dental benefit plans be designed or operated like medical insurance plans."


[FONT=Arial,Helvetica,sans-serif][SIZE=-1] J Am Dent Assoc, Vol 137, No 6, 801-806.[/SIZE].

.


Enlightening.
 
I thought the NY Times piece was accurate of what typically exists in many states in the US unfortunately. I'm here to defend my profession against some of the uninformed ignorance posted here. Denturists are legally recognized Dental professionals in 7 states in the US. They are also recognized in Canada,the UK, Australia, and many European countries.
Let's not forget why this is such an issue of debate. The facts are that the majority of US dental schools have virtually eliminated curriculum related to dentures and partials. Some schools have made it an elective. Are any of you aware that Bates College in WA has a Denturist Program that has 2-3 times the clinical requirement in dentures and partial dentures that Harvard's dental school has?
 
I thought the NY Times piece was accurate of what typically exists in many states in the US unfortunately. I'm here to defend my profession against some of the uninformed ignorance posted here. Denturists are legally recognized Dental professionals in 7 states in the US. They are also recognized in Canada,the UK, Australia, and many European countries.
Let's not forget why this is such an issue of debate. The facts are that the majority of US dental schools have virtually eliminated curriculum related to dentures and partials. Some schools have made it an elective. Are any of you aware that Bates College in WA has a Denturist Program that has 2-3 times the clinical requirement in dentures and partial dentures that Harvard's dental school has?

I'm not disputing the fact that dentures are being phased out of dental curricula. That being said, denturists such as yourself are a very dangerous proposition without the guidance of a dentist. I have no doubt that you have a great ability to make a nice denture (probably better than many dentists), but without knowledge of pharmacology, oral medicine, and such, you can be placing patients at a great risk of problems which you do not have the training or ability to treat. Denturists working with dentists are a decent idea, but on their own is simply not fair to the patient.
 
I'm not disputing the fact that dentures are being phased out of dental curricula. That being said, denturists such as yourself are a very dangerous proposition without the guidance of a dentist. I have no doubt that you have a great ability to make a nice denture (probably better than many dentists), but without knowledge of pharmacology, oral medicine, and such, you can be placing patients at a great risk of problems which you do not have the training or ability to treat. Denturists working with dentists are a decent idea, but on their own is simply not fair to the patient.

This kinda seems like a territory pissing contest to me.
 
I'm not disputing the fact that dentures are being phased out of dental curricula. That being said, denturists such as yourself are a very dangerous proposition without the guidance of a dentist. I have no doubt that you have a great ability to make a nice denture (probably better than many dentists), but without knowledge of pharmacology, oral medicine, and such, you can be placing patients at a great risk of problems which you do not have the training or ability to treat. Denturists working with dentists are a decent idea, but on their own is simply not fair to the patient.


I don't mind denturists working with a dentist in their office so they can work as a team just like a dental hygienist working with a dentist. They need each other. I don't think that they should work independent because you never know when you might need that dentist there with you. They may also need you to perfect the denture when they can't. If you want to separate that into a specialty-like field then that's why you have a prosthodontist. They specailize in prosthetic. Not only you have to fight the general dentist but you have to fight the specialist also. This is their expertise.
 
I can tell you that after 15 years experience as a practicing Denturist, I have seen many, many denture cases come to me where Dentists, and Prosthodontists have left dentures over-extended and caused a tremendous amount of trauma especially to anterior vestibular areas, including not clearing the denture in the area of the labial frenum. We won't even get into the harm that I have seen from poor chrome partial design.

In addition I consulted a patient recently who had just come from her Dentist and spent $6,000 US for a full upper denture which was ill-fitting, and a wrought wire lower, which I consider a temporary measure, but she was told was the permanent finished product. After my initial exam, I observed a rather obvious leukoplakia, which she was not told about at her Dentist. I referred this patient out. Denturists are trained to examine normal oral anatomy, how to recognize different oral diseases and abnormalities.

I know good Dentists and bad ones who are in such a rush to make the almighty dollar. I'm just as sure that there are good Denturists and bad ones as well, but one thing I can tell you is that Denturist programs DO in fact include general and dental pharmacology courses, in addition to general embryology and dental embryology, histology, microbiology and infection control, radio graph reading, and countless other courses which indeed prepare us to do the best for our patients without risking their health as you assert. Denturists who choose to practice on their own are trained to refer to a Dentist when they determine that there is a need to. And we are qualified to make that determination.

As for the Prosthodontist, as Denturists we still have a lot more clinical experience in our programs than they do pertaining to removable prosthetics, (I know this because the instructor of the program I went through is a Prosthodontist) and in addition most of us can actually create a denture with OUR own hands and have been doing so for many years, giving us invaluable insight. Think of the thousands of dental casts that the average technician has created prosthesis over. He has observed that anatomy, and what works over that foundation for years before he enters a Denturist program. That is why we excel at what we do far more than most Dentists and Prosthodontists. That is why the public has made sure that our efforts for professional recognition have met with success in 7 states in the US, and just about everywhere else in the world. Dentistry's monopoly grip on dentures, and their desperate attempts at holding on to this service has caused harm to the public. I challenge you to find one case of a real Denturist (and by that I mean a state licensed Denturist,not some quack operating out of a garage) that has caused harm to the public. You won't because there is none.

Now, I happen to agree that it is good to have a team of professionals who mutually respect each others knowledge of their specialty. FutureDMD, you said that Denturists are a very dangerous proposition without the guidance of a Dentist? Please explain.How many Dentists do you suppose call their laboratory and ask them what materials and design they should use on an edentulous or partially edentulous patient? How many do you think write on their work order "make denture", or "design chrome partial"? I can assure you that it's the majority after having successfully run a prosthetic laboratory for many years.The fact is that in most prosthetic cases it is the Dentist that needs the Dental Technician's guidance to achieve success.

My point is that we need to recognize each other as professionals, and unfortunately that day has not yet come to a great extent. And we are here to stay despite the ADA's long standing policy against us. Even state dental associations and many dentists have seen the light. In fact in the states Denturism is practiced many Dentists and Denturists work together through referrals. I am hopeful that the newer generations of Dentists and Denturists can put aside these differences in order to concentrate on what's most important, their patients.
AzDenturist
 
Well, that's some nice prose you wrote there but do you have any actual evidence besides conjecture and anecdotes that prove the average denturist can outperform the average dentist, let alone prosthodontist? That a denturists clinical judgement regarding oral and systemic disease is at an acceptable level to see patients on their own? Chiropractors take what I will grudgingly call "anatomy and pharmacology" courses as well, but that doesn't give them license to prescribe medication or diagnose disease.

You also consistently claim (along with Denturist) that dentists and the ADA are solely interested in money, which is a ridiculous assertion coming from someone who I'm guessing is a monetarily invested in denturism as yourself. I see literally no problem with having denturists practice under dentists, just like every other medical and dental auxilliary, but for some reason that's unacceptable. Why? Aren't we still doing the patient a service?
 
I can tell you that after 15 years experience as a practicing Denturist, I have seen many, many denture cases come to me where Dentists, and Prosthodontists have left dentures over-extended and caused a tremendous amount of trauma especially to anterior vestibular areas, including not clearing the denture in the area of the labial frenum. We won't even get into the harm that I have seen from poor chrome partial design.

In addition I consulted a patient recently who had just come from her Dentist and spent $6,000 US for a full upper denture which was ill-fitting, and a wrought wire lower, which I consider a temporary measure, but she was told was the permanent finished product. After my initial exam, I observed a rather obvious leukoplakia, which she was not told about at her Dentist. I referred this patient out. Denturists are trained to examine normal oral anatomy, how to recognize different oral diseases and abnormalities.

I know good Dentists and bad ones who are in such a rush to make the almighty dollar. I'm just as sure that there are good Denturists and bad ones as well, but one thing I can tell you is that Denturist programs DO in fact include general and dental pharmacology courses, in addition to general embryology and dental embryology, histology, microbiology and infection control, radio graph reading, and countless other courses which indeed prepare us to do the best for our patients without risking their health as you assert. Denturists who choose to practice on their own are trained to refer to a Dentist when they determine that there is a need to. And we are qualified to make that determination.

As for the Prosthodontist, as Denturists we still have a lot more clinical experience in our programs than they do pertaining to removable prosthetics, (I know this because the instructor of the program I went through is a Prosthodontist) and in addition most of us can actually create a denture with OUR own hands and have been doing so for many years, giving us invaluable insight. Think of the thousands of dental casts that the average technician has created prosthesis over. He has observed that anatomy, and what works over that foundation for years before he enters a Denturist program. That is why we excel at what we do far more than most Dentists and Prosthodontists. That is why the public has made sure that our efforts for professional recognition have met with success in 7 states in the US, and just about everywhere else in the world. Dentistry's monopoly grip on dentures, and their desperate attempts at holding on to this service has caused harm to the public. I challenge you to find one case of a real Denturist (and by that I mean a state licensed Denturist,not some quack operating out of a garage) that has caused harm to the public. You won't because there is none.

Now, I happen to agree that it is good to have a team of professionals who mutually respect each others knowledge of their specialty. FutureDMD, you said that Denturists are a very dangerous proposition without the guidance of a Dentist? Please explain.How many Dentists do you suppose call their laboratory and ask them what materials and design they should use on an edentulous or partially edentulous patient? How many do you think write on their work order "make denture", or "design chrome partial"? I can assure you that it's the majority after having successfully run a prosthetic laboratory for many years.The fact is that in most prosthetic cases it is the Dentist that needs the Dental Technician's guidance to achieve success.

My point is that we need to recognize each other as professionals, and unfortunately that day has not yet come to a great extent. And we are here to stay despite the ADA's long standing policy against us. Even state dental associations and many dentists have seen the light. In fact in the states Denturism is practiced many Dentists and Denturists work together through referrals. I am hopeful that the newer generations of Dentists and Denturists can put aside these differences in order to concentrate on what's most important, their patients.
AzDenturist



I'm not exactly saying that denturists are dangerous without the dentist present. I just want them working as a team. If you have to take all those extra classes to be a denturist, why not go to dental school? Why do you want to practice independently like you are another dentist competing? If you make a mistake, for example, missing a lession in the patient's mouth that could be oral cancer and you are going to take the fall. If you were working for a dentist, that's another story. About that comment of dentists charging so much for dentures, why do you want to become a denturist? So you can make more money and compete with the dentists to make all the profit out of dentures like a businessman. Hell, what's next? "crownist" or "implantist"? Dental assistant want to diagnose and treat also along with dental hygienist?
 
If you have to take all those extra classes to be a denturist, why not go to go to dental school?

And why don't we all go to med school before dental school, since dentistry is really just a specialty of medicine? And as we are learning more and more as time goes on, health in the body and health in the mouth are intimately related. We could sit in school for 4 more years learning heaps of minimally useful information, which we will just forget after a few years anyway.
 
I wouldn't worry about it, the NY times obviously doesn't have anything better to write about.
 
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