Students Perspective on current issues in JADA

[DentStud]

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Hi everyone! I have an idea to make this forum even more interesting and and educational! I love reading JADA (Journal of the American Dental Association) as well as other publications in our profession. There's usually very interesting and controversial issues, such as the LETTERS and VIEW sections. So I want bring those topics to this forum so that we can all share our views and ideas on these subjects! So here is my suggestion: Pick anything that interests you that you read from the most current issue of JADA and start a new forum by typing the keywords in the subject so that we all can add our inputs.

To start off, here is something that caught my interest from the Jan. 2002 JADA:

There was a physician's reply on the topic of physicians in North Carolina delivering preventive dental services to children. Should it be legal? Does it hurt or help the dental profession? My view on this is that if dentists are not willing or not accessible to treating these kids, then those physicians are doing a wonderful service for those needy kids. I don't see a problem with it. WHAT DO YOU THINK???

By the way, I want to applause DrJeff, I have read most of his insights on this forum, he is truly a Doctor in all senses of the word! Go DrJeff!

 

[Dr. Pedo]

Preventive dentistry---what are they providing? Are they doing fluoride treatments, dental cleaning, educations???? If they are entering the oral cavity other than to check for swollen tonsils they best be getting some dental education. Simply knowing the histological aspect of the oral cavity doesn't make them a dentist-----let alone a peds. dentist, which by the way is another 2-3yrs of additional training after dental school---- for a reason. I think it is scary that a physician would even consider trying to provide a service they have absolutely no training in.

 

[DrJeff]

To my understanding, and some additional insight from one of my former dental school roommates who practices in the rural mountains of NC near the VA border, most of the "preventative care" that is proposed is the administration of topical flouride and flouride varnishes. While this will be of little help for advanced carious lesions, it can be of benefit for incipient lesions and preventative purposes in an underserved population.

The main issue here is not a medical professional administering dental tx, but kids from an underserved population getting SOME basic preventative care. Obviously if an MD looks in and sees a large carious lesion(most MD's/DO's won't be able to recognize a carious lesion until it is of a size that pulpal involvement is highly likely)they will refer to a dentist. The real, and unfortunate problem is then the economics of the situation. Most patients on state welfare programs(the exact population that this NC proposal is targeting) have much less dental provider choices than medical provider choices(you can thank dentistry's resistance to dental HMO's for this). Reason being is that most state welfare dental program reimbursement rates to dentists are at best at a level that will just cover your expenses, most are below your expense levels! <img src="graemlins/wowie.gif" border="0" alt="[Wowie]" /> You can see what will happen if your practice has a high quantity of state welfare patients, you can't cover your expenses(i.e. employee's salaries, student loan payments, your mortgage payment). It is really a sad situation sometimes. This NC proposal will atleast get some very basic preventative treatment to a population that needs it, and if an MD gets reimbursed the $2 (that's what CT state welfare reimburses me for the $30 that I bill for a flouride tx), I can live with that.

I will also add that yes I do have state welfare patients in my practice, granted it's only a select few who are generally relatives of other patients in my practice. Last year though between my partner and I the ooffice wrote off the difference between what we billed and what the state reimbursed us to the tune of over 35,000 of treatment to those patients.

This is going to be a really challenging problem in dentistry as the number of practicing dentists continues to shrink each year, how do we treat the welfare population and still pay our bills <img src="confused.gif" border="0">

 

[DentStud]

Yes, this is not an issue that can be easily resolved! Call me an idealist, but I think that if we in the dental profession want to tackle this problem, it can be done. I think it's important for dental institutions to instill community and voluntary efforts in dental students early in their career, i.e. while they're in dental school. A day or two out of the month to volunteer to help the children in need is not a lot to ask for. I don't support MDs doing dentistry, but I see no harm in providing fluoride varnishes and sealants and education on prevention, especially like Dr. Jeff mentioned that they are not doing it for the money. Surely, I won't support an MD picking up a handpiece and doing a cavity prep. That would definitely jeopardize the autonomy that we have as a profession!

 

[lalo5]

here is an interesting topic, and one for which i'm sure that many dentists can relate;
This topic comes from the November 2001 issue, and it was an article written by Gorden Christensen, about treating the potential problem patient.
does anyone have any experiences/advice that they could contribute to this topic??

lalo5

 

[lalo5]

does anyone have anything to contribute to this type of situation?? 😀