"Dollars and Dentists" by FRONTLINE in association with the Center for Public Integrity, premiered last night on PBS. The investigative program focused on access to care by the poor and Medicaid fraud by larger group practices. It is hard as a dentist to not be frustrated by their portrayal. There are a multitude of factors that contribute to rampant dental disease. Lack of care is only one of them. The ADA's response to this program mirrors this sentiment:

"There are right ways and wrong ways to improve access to dental care in America. The right way is to understand that while oral health care is essential, the ultimate goal is oral health. The right way is to recognize that there are multiple barriers that impede tens of millions of Americans from attaining optimal oral health, including geography, culture, language, poverty and, in the larger sense, a societal failure to value oral health. Taking on just one of them won't work; we must continue to approach the problems holistically. The wrong way is to invest solely in therapist programs that other countries have used for decades, with little appreciable effect on their rates of oral disease.

The country will never drill, fill and extract its way to victory over untreated dental disease."

Simply allowing wholesale adoption of dental therapists is not a silver bullet. As every dentist knows, no single dental procedure is ever exactly the same. Changes to the course of treatment occur frequently. How will a dental therapist handle a situation that becomes surgical without the training of a dentist? I am not necessarily opposed to their role in a preventative role but the last line of the above quote sums the situation best.

It will take comprehensive reform to increase access to care as well as education initiatives to properly address this issue. Currently, we are incentivizing the wrong behaviors on the part of the patients as well as the dentists and the situation needs to be reformed.

Let us know your thoughts below.


Comments

Commenter's Profile Image Lee Ann Brady
June 28th, 2012
Martin, Very Well Said and thanks for taking th etime to respond publicly! Lee
Commenter's Profile Image Chad Perry
June 28th, 2012
Ditto to what Lee Ann said. Very well put!
Commenter's Profile Image Gary Takacs
June 28th, 2012
Martin, I appreciate your response to the PBS Frontline show titled, 'Dollars and Dentists'. While the show did raise some important points regarding access to dental care and very low Medicaid reimbursement rates in many states, I found the tone of the story to be offensive on a number of levels. It portrayed Dentists as money-grubbing and the show also implied that making a profit is somehow contradictory to caring about patients. The biggest glaring deficiency in this show was the lack of any discussion about personal responsibility for oral health. People don''t just wake up one day with horrible oral health. It usually is a result of years of neglecting basic home care. Parents are responsible for the oral health of their young children. Part of the solution to what the show characterized as the 'Dental Crisis in the US' will be educating people to make good decisions about their oral health. The good news about the show is that people are talking about dentistry! Thanks again for your response. Gary Takacs
Commenter's Profile Image Martin
June 28th, 2012
Thanks for all the comments! Gary, I couldn't agree more. It was not mentioned as a significant factor. With all of the billions that are made from tooth pastes, mouth rinses, OTC bleaching and the like, why are we not pressuring the large oral care companies to spend a little bit of $ and help us with public awareness campaigns relating to Baby Bottle Caries, the dangers of sipping sodas etc?? Why was this not addressed?? We can provide preventive care & drill and fill the lesions away but without good home care and education it will all be for nought!!