For want of a dentist

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Walleye

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WASHINGTON - Twelve-year-old Deamonte Driver died of a toothache Sunday.

A routine, $80 tooth extraction might have saved him.

If his mother had been insured.
<snip>

By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.

Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

http://www.msnbc.msn.com/id/17372104
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Just read the entire article... Crazy how an $80 tooth extraction could save a life and also prevent a family from incurring a $250 000 hospital bill. Unfortunate that lack of dental care due to no coverage will always be a problem.
 
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That is so crazy, just shows how much people take going to the dentist for granted. I know I used to...
 
That is so sad. I wonder how much time it took to get that bad.
 
Healthcare needs to be reformed so people can actually afford the healthcare they need. This really is sad, but it's the reality for so many people out there that aren't covered.

From my perspective, they can start by making education a priority in this country and by decreasing student's tuition costs.

Everyone complains about the cost of healthcare, but if they were faced with the kind of debt we'll be looking at they might understand the high prices.

Personally, and I'm just feeling a tad cynical right now, I want to charge the baby boomers an arm and a leg for healthcare. Hell, by the time we get up there, social security will be bankrupt and we will have in essence (for those of us that have had to work the past 5-10 years or so) contributed to their retirement while getting nothing in return. OK, maybe it won't go bankrupt...I digress.
 
And get rid of all the lawyers...that should decrease the costs. But I guess that wouldn't work because then we'd have to get rid of the government since most of them are lawyers.

Hmmm...maybe it would.
 
That article is so sad. I'm not a parent, but that's so heartbreaking.
 
KOM said:
Healthcare needs to be reformed so people can actually afford the healthcare they need. This really is sad, but it's the reality for so many people out there that aren't covered.

From my perspective, they can start by making education a priority in this country and by decreasing student's tuition costs.

Everyone complains about the cost of healthcare, but if they were faced with the kind of debt we'll be looking at they might understand the high prices.
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Absolutely!!! People think docs and dentists make soooo much money and they are so greedy, and should cut their costs. Did those people ever consider that the person has $200k tution debt+$200k (at least!) mortgage+ kids+ family+taxes??!?! A $100k salary is highly reduced after all of these factors.

Its really just a horrible cycle, schools cost so much and gives students an incredible amount of debt. So these students then graduate, attempt to go to competitve specialties for more $$$$ or practice in more affluent areas of town. Then people wonder why there isn't more broad representation of dentists in less affluent areas. If school didn't cost hundreds of thousands of dollars, then I'd have no problem charging less and earning less. Eventually the gap between healthcare coverage for the poor and middle/upper class widens and less people get the care they need.
 
beat me to it..:thumbup:

Do you guys know how much do dentists get from Medicaid/Medicare?
The guy I shadow told me he stopped taking all kinds of insurance because he would only get about 40% of the procedure from them. Instead, he collects full price and makes the patients go through their own insurance for reimbursement. Kinda sucks, but it explains his annual 400K.
 
prez_al said:
Just read the entire article... Crazy how an $80 tooth extraction could save a life and also prevent a family from incurring a $250 000 hospital bill. Unfortunate that lack of dental care due to no coverage will always be a problem.
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$80 only covers my wife's first consultation with an X-Ray taken. And damn, the dentist only spent less than a minute talking to her, saying she needs tooth extraction ($350 extra), and a bridge ($4500 extra). Now tell me folks, who on earth would think that this could sensibly make people affod the bills. Yes, there's payment plans offered. But this option can only kill us in the long run.:(
 
What's crazy is that many cans of soda, gummy bears and parental neglect can kill a child. Now thats the real story.
 
diagnodent said:
What's crazy is that many cans of soda, gummy bears and parental neglect can kill a child. Now thats the real story.
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You're absolute correct! It's interesting how the story doesn't mention February was children's dental health month....a month where thousands of dentist across the US provide free dental care (pro bono) to hard luck cases.
She could have found someone to help her if she didn't neglect her childrens dental health.
 
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This is a really sad story :(

If the extraction was only $80, why didn't the mother just pay the bill for it? Not to sound cold, but both sons had multiple cavities and abscesses in their mouths. The pain had to be intense and noticeable for months, what was done about that?

There's blame to be spread around of course, the immediate dentists who coldly put the family off when it was obvious the kid needed attention asap, the state governments who refuse to pay market price for dental procedures when it'll ultimately cost more ($250k versus $80), parents who don't keep a closer watch on their children.

With the advanced state of decay in the kid's mouth, even if they filled the cavities in time or pulled the rotten teeth out, he was well on his way to losing all his teeth anyway. Fillings, root canals, and extractions only treat the symptoms of oral disease, the teeth still rot after the procedures are done if habits aren't changed.

It's not for want of an $80 procedure that this kid died, it's for want of $5 for toothpaste, a toothbrush, regular brushing and cutting back on candy and soda drinks. Before we start mandating government control of dentists, how about parents taking more responsibility over their children's health.

On a side note, as baby boomers age and start demanding their politicians for universal dental care to go along with healthcare, dentists are going to face further backlash. Stories like this will galvanize the general populace to demand governments get involved. The freedom from having to deal with insurance companies and governments that dentists have enjoyed while doctors have been squeezed isn't guaranteed.

As a group we dentists are going to have to be much more willing to do volunteer work, public relations and get involved in politics.
 
So a kid dies and everyone blames the dentist and their lack of taking medicaid...that makes total sense:rolleyes:

Did anyone see the poll?
Poll on medicaid

Interesting how an article can sway people in one way or another.

No one ever blames the poor parents who probably ignored their kids whining because they were too lazy themselves to car to get the kid the attention they needed in the first place.

I am all for helping people out in the struggle of life. If my office was in her area and she came in pleading for help I would have done it as most people would. Blaming the system though is not the heart of the issue, lets blame the person in the system who seems like the easiest target. Unfortunately many people feel they are a victim of society and deserve extra attention.

I feel for the family that lost that boy. That is horrible. Don't sway the issue though to make dentists the bad guys because they don't want to use a sucky government program that takes half the money and requires more paperwork and effort than needs be.
 
the general public believes that our country has infinite resources, and there's enough to spread around with no cost, and that everyone can be taken care of.

we have finite resources, we have to allocate as best we can. if we start forcing dentists to accept lower rates (i.e., price control), there will still be a cost. salaries will go down, and less dentists will ultimately enter the profession. overall dental care for everyone will worsen.

easier to blame someone else than to take personal responsibility..
 
Medicaid pays very little reimburstment. So essentially people expect dentists with hundreds of thousands of dollars of debt to make hardly any profit. We would all be bankrupt if that was the case.

The funny thing is that many (of course not all) dental problems can be prevented by $1 pack of floss, $2 toothpaste and $1 toothbrush. I'd say it probably costs $50 or less a year to do this prevention. You could probably even find a clinic/health department that would give away these supplies for free.

Yet people complain procedures are too expensive. Why didn't you spend $4 for preventative maintance in the first place?
 
ItsGavinC said:
I blame the parent. Afterall, the dentist didn't put give the kid the toothache. Of course, it's probably everybody else's fault before it's the parent/child's fault.
Click to expand...

Very, very true. My gf is an elementary school teacher, and you wouldn't believe how much the parents blame on everyone else as soon as the child acts out of line and give the same old "They don't act that way at home so it must be something you teach him/her". Give me a break!
 
This whole medical/dental healthcare situation is much more complex than simply being able to afford care. Even when dental care is provided for free, the inability to access proper treatment adds another barrier for many people. And you dont have to be poor, elderly or a minority for you to be affected by it. If your dental school administration and leaders give a hoot and hope to inspire you to do something about it, they'll make sure that you get more than a 20 minute lecture on the subject during your dental school education. Thats something to ask about during your interviews....
 
Payment for procedures is so messed up. I ran a doctor's office for a little over a year and we NEVER got more than 50% payment for bills we sent out. There needs to be serious reform in the United States, but I don't think it should be with healthcare. Healthcare isn't the problem. The problem are our insurance companies not paying medical and dental professionals for the work done. When they aren't paid in full they have to find other ways to get paid. I saw a lot of corruption where I worked because of it. In the end it is the consumer who is getting screwed. Insurance Companies need to get heavier governmental regulation placed on them. They are really corrupt and basically ruining our healthcare system. And I do agree that parents need to take more responsibility for what happens to their children. A problem can only be fixed if it is addressed.
 
I just have to add that in my hometown, we have a free clinic that does tooth extractions every other tuesday night, free. That's right, it's free, and you don't have to have insurance or anything. That's all I'm saying...
 
lnsip9reg said:
This is a really sad story :(

If the extraction was only $80, why didn't the mother just pay the bill for it? Not to sound cold, but both sons had multiple cavities and abscesses in their mouths. The pain had to be intense and noticeable for months, what was done about that?

There's blame to be spread around of course, the immediate dentists who coldly put the family off when it was obvious the kid needed attention asap, the state governments who refuse to pay market price for dental procedures when it'll ultimately cost more ($250k versus $80), parents who don't keep a closer watch on their children..
Click to expand...

I am sorry this family had to lose their son. There was a similar case in the Bronx in 2005. But it's not as simple as the article makes it seem.

At first I too thought "Only $80? These people probably have a cell phone, cable TV, SUV, designer clothes and just refuse to pay for an extraction." But after reading the article, it seems like the family is really hard pressed for $80 - homeless, lack of transportation, etc. I wouldn't judge right away. It doesnt' make it right, but if it doesn't hurt, it's probably going to get ignored which the article implies since the other kid complained more about toothaches. They went to the ER when the kid said he had a headache and got the appropriate ER care (sounds like antibiotics), but it doesn't say when the child got more sick (the next day? 5 days later? It can make a difference.).

I wouldn't blame the dentist right away. The other son was seen by a dentist who referred him to an oral surgeon for the extractions, an acceptable course of action for a general dentist. The article doesn't mention if the son who died was seen by the dentist.

Any of the oral surgery residents will tell you that this story isn't new. In my GPR, we often saw patients show up in the ER for a toothache. We'd give the appropriate ER care, and tell them to return the next day for the extraction to solve their toothache problem. The majority of the time, if the tooth hurt less after the trip to the ER, the patient never came back for the extraction. The next time we saw the patient would be when he/she would show up in the ER again, this time the tooth was so out of control that the patient has to be admitted to the hospital and the extraction can no longer be done in the clinic - hello operating room, new medical problems related to the now out-of-control abscessed tooth, and hugely increased cost of care.
 
What a great set of priorities. This kid dies, and your only response is to spring a hard-on over how you (mistakenly, btw) think it's going to increase your salary. That's terrific.
 
gryffindor said:
At first I too thought "Only $80? These people probably have a cell phone, cable TV, SUV, designer clothes and just refuse to pay for an extraction." But after reading the article, it seems like the family is really hard pressed for $80 - homeless, lack of transportation, etc. I wouldn't judge right away.
Click to expand...

Don't forget the journalist's ability to blow things out of proportion.

One of the most irritating things about residency is the constant griping from patients. In our clinic, we only see walk-ins long enough to see if they have any facial swelling or not. If they do, we sign them in and take care of them. If not, they get an appointment (which is roughly a year out). I get unbelieveably tired of listening to the same bullsh*t from these patients -- how they have no money, can't afford to go anywhere else, etc. My first question always is, "Do you smoke?" Usually yes, so I tell them to quit smoking for a month and they'll be able to afford an appointment with someone who will see them sooner. I've had a girl wearing Diesel shoes try to tell me she had no money. After telling me she couldn't afford to go to a dentist, I nonchalantly asked a "walk-in" wearing a R. Kelly concert shirt if she had been there. She got excited, "Oh, yeah! I sat third row!" It's all a matter of priorities. The system is so abused that I've lost all confidence in it. I can promise you that I will not do ANY Medicaid when I finish residency. My pro bono work will be in other countries, where people will actually appreciate what I'm doing for them.

Don't get me wrong, I do feel sorry for the kid. It's sad that he drew the short straw in the parental draft. That said, it's the parents' fault that he died. If I had no money and my child was in pain, I would find a way to get him taken care of. Period. Playing the poor card is unacceptable.
 
OMFSCardsFan said:
The system is so abused that I've lost all confidence in it. I can promise you that I will not do ANY Medicaid when I finish residency. My pro bono work will be in other countries, where people will actually appreciate what I'm doing for them.

Don't get me wrong, I do feel sorry for the kid. It's sad that he drew the short straw in the parental draft. That said, it's the parents' fault that he died. If I had no money and my child was in pain, I would find a way to get him taken care of. Period. Playing the poor card is unacceptable.
Click to expand...

Amen, amen, amen.
 
I will not sign up for Medicare/Medicaid as is. I'll volunteer my services for free, but I will not deal with the government. They'll get their 40% and that'll be the end of that.
 
Simiam said:
Insurance Companies need to get heavier governmental regulation placed on them. They are really corrupt and basically ruining our healthcare system.
Click to expand...

Yes, let's give the government more power. :eek:
 
soccergolfrws39 said:
I just have to add that in my hometown, we have a free clinic that does tooth extractions every other tuesday night, free. That's right, it's free, and you don't have to have insurance or anything. That's all I'm saying...
Click to expand...

In addition to free clinics, Texas has a free dental care program called Texas Mission of Mercy. It is a widely publicized event that happens a couple times a year at various cities throughout the state. The resources are always available, it's a matter of taking the time to get out and find them.
 
Something good will be happening in Grand Forks, ND. It doesn't matter if anyone likes the kid's parents, children shouldn't suffer like that child did, even prisoners get better treatment. I was fortunate that I had dental insurance, parents that cared, sealants,cleanings, fluoride, and braces.... I had my share of gummy worms and coke, I admit. I still have yet to have my first cavity and really hadn't thought that kids were living with such terrible pain. It certainly is hard to get it out of my mind, maybe this will be a wake up call to the public, and there will be more programs like Grand Forks. In rural areas, we have very few dentists period, much less programs like this. Wish I could put the whole article on, I think there are good ideas like hygienists in schools and prevention. Raising public awareness of dental health can only be good?

www.gfherald.com (registration required)
A reason to smile for dental health
By Kevin Bonham
Herald Staff Writer - 03/01/2007
The old Deaconess Hospital in Grand Forks soon will be home to a health care facility for the first time in about 30 years.

The Northern Valley Dental Alliance, a public health clinic that will serve Grand Forks and Polk counties, could open at 212 S. 4th St. as early as this summer.

The public dental health clinic is designed as an oral health safety net, serving Medicaid recipients and their families, as well as the uninsured or underinsured.

"We have a serious problem with access to dental care in our community," said Debbie Swanson, nursing and nutrition supervisor with the Grand Forks Public Health Department.

About 7,500 Medicaid recipients, including nearly 4,300 children, in Grand Forks and Polk counties have little or no access to dental care.

That's because very few dentists just two of about 30 in Grand Forks County treat Medicaid recipients or their families. The reason is Medicaid reimburses dentists an average of just about 55 percent of their treatment costs, according to the North Dakota Department of Human Services.

"The whole community needs to be involved in these problems," said Sharon Ericson, CEO of Valley Community Health Centers in Northwood, N.D.
 
We all should consider that medicaid only provides dental care to CHILDREN, not the adults. So, for that reason, I will accept medicaid. We can't blame the children for their parents shortcomings or predicament.
 
This is why I wil take medicaid.
 
OMFSCardsFan said:
Don't forget the journalist's ability to blow things out of proportion.

One of the most irritating things about residency is the constant griping from patients. In our clinic, we only see walk-ins long enough to see if they have any facial swelling or not. If they do, we sign them in and take care of them. If not, they get an appointment (which is roughly a year out). I get unbelieveably tired of listening to the same bullsh*t from these patients -- how they have no money, can't afford to go anywhere else, etc. My first question always is, "Do you smoke?" Usually yes, so I tell them to quit smoking for a month and they'll be able to afford an appointment with someone who will see them sooner. I've had a girl wearing Diesel shoes try to tell me she had no money. After telling me she couldn't afford to go to a dentist, I nonchalantly asked a "walk-in" wearing a R. Kelly concert shirt if she had been there. She got excited, "Oh, yeah! I sat third row!" It's all a matter of priorities. The system is so abused that I've lost all confidence in it. I can promise you that I will not do ANY Medicaid when I finish residency. My pro bono work will be in other countries, where people will actually appreciate what I'm doing for them.

Don't get me wrong, I do feel sorry for the kid. It's sad that he drew the short straw in the parental draft. That said, it's the parents' fault that he died. If I had no money and my child was in pain, I would find a way to get him taken care of. Period. Playing the poor card is unacceptable.
Click to expand...

Yeah, dude....I can't tell you how many times i heard that same sob story....funny how they will go smoke 2 packs a day....drink a 5th of Jack a week.....but have "NO money". I've also given up. As soon as they walk in...I've got the syringe in hand....carpule cocked and loaded....doing a med hx ....as i go in for the IA block.....
 
LSU-Cowboy said:
Yeah, dude....I can't tell you how many times i heard that same sob story....funny how they will go smoke 2 packs a day....drink a 5th of Jack a week.....but have "NO money". I've also given up. As soon as they walk in...I've got the syringe in hand....carpule cocked and loaded....doing a med hx ....as i go in for the IA block.....
Click to expand...

Funny you should say that. My parents got me one of those daily cartoon calenders called "The Dentist's Office" for 2007 and here is todays cartoon:

Dentist:The gold crown runs about $600

Patient (Wearing polo shirt, rolex, gold chains, cell phone):Is that covered by Medicaid?

Dentist: No.

Patient: Well I couldn't afford that.
 
jr8047 said:
We all should consider that medicaid only provides dental care to CHILDREN, not the adults. So, for that reason, I will accept medicaid. We can't blame the children for their parents shortcomings or predicament.
Click to expand...

No one is saying "Blame the children." Just remember that you still have to deal with the parents. We'll see how long it takes for you to change your mind when the following things happen in your practice:

-The majority of Medicaid patients consistently miss appointments. Oh, but your office staff will probably understand and offer to not be paid for that hour.

-The majority of Medicaid patients will not appreciate or respect anything that you do. They will complain, argue, attempt to intimidate, etc. That is how their "society" functions.

-You're paying, appreciative patients who show up for appointments will be upset about having to wait longer times for appointments.

Trust me, as soon as your schedule starts filling up two months out, you'll be looking at the Medicaid slots in a whole different way. Especially after you realize what it's like to deal with them.

Think about how many people in your class would say the same thing: "Oh, yes, I have a responsibility to my fellow man. I am going to do the right thing and accept Medicaid." Then think about how many people are actually accepting it.

It's kind of like oral surgery interviewees. Almost every one says they want to be an academic -- so where are we getting all the private practice guys?
 
i heard rumours that insurance companies own some private dental schools.
is this true ???? anybody knows about this???
 
OMFSCardsFan said:
-You're paying, appreciative patients who show up for appointments will be upset about having to wait longer times for appointments.
Click to expand...

And they don't have anywhere to sit in your waiting room because 1 medicaid patient usually brings about 7 other nephews/cousins/neighbors kids/sisters, etc.
 
drpduck said:
Very, very true. My gf is an elementary school teacher, and you wouldn't believe how much the parents blame on everyone else as soon as the child acts out of line and give the same old "They don't act that way at home so it must be something you teach him/her". Give me a break!
Click to expand...

I hear the same thing from my gf who is a 1st grade teacher.
 
jr8047 said:
We all should consider that medicaid only provides dental care to CHILDREN, not the adults. So, for that reason, I will accept medicaid. We can't blame the children for their parents shortcomings or predicament.
Click to expand...

Actually medicaid provides dental care to both adults and children, in most states anyway I believe. They have a different reimbursement rate (much less for adults) and you can choose to only accept medicaid for children if you want. In Michigan the reimbursement is pretty bad - for a 1 surface filling about $40 for a kid and only $15 for an adult.
 
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