Really Awful Article on Dentistry

The NY Times outdid itself last week with a truly awful article on dentistry.  They started with just one fact:

Previously unreleased figures from the Centers for Disease Control and Prevention
show that in 2003 and 2004, the most recent years with data available,
27 percent of children and 29 percent of adults had cavities going
untreated. The level of untreated decay was the highest since the late
1980s and significantly higher than that found in a survey from 1999 to
2002.

They then apply the patented NY Times class-based story-generation model to assume a cause for this rise that is not supported by the study itself:

But many poor and lower-middle-class families do not receive adequate
care, in part because most dentists want customers who can pay cash or
have private insurance, and they do not accept Medicaid
patients. As a result, publicly supported dental clinics have
months-long waiting lists even for people who need major surgery for
decayed teeth. At the pediatric clinic managed by the state-supported University of Florida dental school, for example, low-income children must wait six months for surgery.

So is the rise in untreated dental problems concentrated in the poor?  Well, they don't say, and there is not data for that in the study, but that does not prevent the NY Times from just assuming it to be so.  In fact, the article itself contradicts this premise, by noting that the problem is not limited to the poor:

The lack of dental care is not restricted to the poor and their
children, the data shows. Experts on oral health say about 100 million
Americans "” including many adults who work and have incomes well above
the poverty line "” are without access to care.

By the way, how did they figure a 100 million don't have "access"?  I don't know, but the figure is suspiciously close to this one:

With dentists' fees rising far faster than inflation and more than 100 million people lacking dental insurance...

Anyone want to bet that the NY Times just made its usual logical fallacy of equating lack of insurance with lack of access?  And by the way, dental insurance is a HORRIBLE investment.  I have priced it many times myself and for a normal family, it is much cheaper to just pay the dental bills, particularly since there are not that many things in your mouth that can go wrong that will be bankrupting.  Trying to push everyone to dental insurance is a terrible idea.  Every time there is a dental procedure in our family, it turns out there are several options for fixing it at different prices.  We actually have the incentive to ask for these alternatives and make trade offs.  What do you think would happen if we had insurnace?

In fact, I can think of a LOT of reasons why people don't go to the dentist as often as they should.  One reason is that no one like the dentist.  Another is people's busy schedules.  And certainly rising costs are a factor -- As I mentioned before, our family makes very different decisions about treatment options than we used to with a fat corporate dental plan.  Which is as it should be. 

By the way, note the screaming socialism here:

The dental profession's critics "” who include public health experts,
some physicians and even some dental school professors "” say that too
many dentists are focused more on money than medicine.

"Most
dentists consider themselves to be in the business of dentistry rather
than the practice of dentistry," said Dr. David A. Nash, a professor of
pediatric dentistry at the University of Kentucky. "I'm a cynic about my profession, but the data are there. It's embarrassing."

I wonder.  Does Dr. Nash accept a salary for being a professor?  Then I guess he is focused more on the business of education than the practice of educating.

Oh, and by the way, how is socialism in dentistry working out?

In a survey of 5,000 people in the UK, six percent claimed that
they had done DIY dentistry, including yanking their own teeth and
fixing cracked crowns with glue. Apparently they resorted to such self
treatment because they couldn't get in to see a National Health Service
dentist "¦

One respondent in Lancashire, northern England, claimed to
have extracted 14 of their own teeth with a pair of pliers. In
Liverpool, one of those collecting data for the survey interviewed
three people who had pulled out their own teeth in one morning.

"I took most of my teeth out in the shed with pliers. I have one to go," another respondent wrote.

  • http://that-xmas.livejournal.com Xmas

    I just use my flex-spending credit card for Dental stuff. The office I worked for offered Dental Insurance, but it's cheaper just to use the tax-deferred money.

    Plus, the dentist is happy because he's paid nearly immediately, so I don't get charged for all of the insurance padding things.

  • http://www.hodakvalue.com/blog M. Hodak

    I was trying to think of some snappy comment relating the NY Times, praise for markets, and pulling teeth, but I'll let others fill in the blanks...

  • http://www.sufficientthrust.com Marina

    I echo that dental insurance is a terrible investment. I pay $164/month for private health insurance through Blue Cross, which offers really good coverage, and they offered dental through a partner for *$60* a month that barely had any benefits.

    If you do find yourself confronted with a big dental bill, you can always sign-up for a dental discount plan for ~$60 if the savings would be worth it.

  • http://highwayx.wordpress.com Highway

    There's also the big shortage of dentists, although that might fit in with the 'greedy dentists' narrative. Another story recently on the subject had a line about how, when there were more dentists per capita, 'some dentists had a hard time keeping practices afloat'. So now they just keep supply low on purpose to protect all the existing dentists.

    Another reason that people don't go is that the dentist makes you schedule appointments 6 months in advance, or you'll never fit in. And if something comes up on the day you were supposed to go, you don't go to the dentist! And good luck getting another appointment, because now they're all booked for another 6 months.

  • agesilaus

    Dental Insurance is worthless, it only gives you a small discount on the Dental fees. However I have noticed that you can buy very cheap dental insurance thru the Sam's Club (and probably other like businesses) that offer about the same discount as the expensive variety. And it only costs something like $30 a year.

    I live in the same town as that UF Dental clinic and they are attached to the Dental school. The clinic is where the students get to practice on live patients. And they are often advertising for new victims. The students are out beating the bushes for people since they have to complete certain procedures to graduate. There are a couple of student in our Church and they were chasing after my wife trying to get her to volunteer and wanted her to bring the kids with her.

  • tsiroth

    I had wisdom tooth extraction surgery under general anesthetic (three teeth, ugh), eight fillings, 5 root canals, and two crowns done at the University of Iowa dental school over about a 15 month period. Advantages: the cost was about 60% less than private practice, the students doing the work are extra careful and very gentle, and there is direct supervision by skilled faculty. Disadvantage: A procedure that would take 30 minutes in a private office may take 3 hours at the dental school. The students are slower through inexperience, and they must wait for faculty to check their "work" after each step.

    I had more time than money, so it was a good deal for me.

  • JoshK

    I agree that dental insurance is a bad deal. But, if you can actually get yourself to do the 2x annual check-ups and take advantage of everything offered, you can do a bit better than break-even. That's hard to do for anyone with a job, however.

  • Larry Sheldon

    Enough has been said about insurance -- we have it and my wife does not spend money on things that don't make sense and that is good enough for me.

    But more importantly, the dentists themselves deserve better treatment than they are getting here.

    In my experience, dentists are the only trade that I know of that are working very hard to put themselves out of business.

    And while I do not have general facts about the Dental Schools in the area (particularly with respect to children) my limited experience escorting other people to the Creighton Dental School has me believing that everybody I saw was treated with considerable respect and outstanding care. (People who know me know that it is very hard for me to say anything nice about any part of Creighton University--the Dental School is one of the exceptions.)

  • Turambar

    Partly as a result, dental fees have risen much faster than inflation. In real dollars, the cost of the average dental procedure rose 25 percent from 1996 to 2004. The average American adult patient now spends roughly $600 annually on dental care, with insurance picking up about half the tab.

    So this crisis about the lack of "access to care" is about $300? And is rising 25% in 8 years really alarming? If anything it is notable because it is such a lower number than general medical rate inflation.

    Perhaps the lesson here is that despite a shortage of dentists, lack of enforced insurance has enforced price sensitivity and hence kept rates down.

  • lkoen1

    Go to Mexico for dental work-just as good care, 1/3 price plus free vacation

  • http://www.myplanpays.com/healthcare Teena

    I use a discount plan for $19.95, which saves up to 80%, for everyone in the house (even if they're not related) While the discounts vary for every procedure, I save money every time I go to the dentist.

  • bbeeman

    "But many poor and lower-middle-class families do not receive adequate care, in part because most dentists want
    customers who can pay cash or have private insurance, and they do not accept Medicaid patients."

    And many don't accept Medicaid for the same reason that medical and dental service diminish under any single-payer scheme. My wife used to work in the dental field, and in our state it turns out that the reimbursement from MediCal (our somewhat plusher version of Medicaid) was not enough to pay for the consumable items used in a normal examination. Plus the fact that even if you got payment from the government it would be six months or more, and in many cases payment was simply never received. So, yes, it's not surprising that Medicaid is not taken.

  • Tim

    "Partly as a result, dental fees have risen much faster than inflation. In real dollars, the cost of the average dental procedure rose 25 percent from 1996 to 2004. The average American adult patient now spends roughly $600 annually on dental care, with insurance picking up about half the tab."

    From our personal experience, $600 per person is far higher than average. A couple of cleanings and a cavity run around $200. What do you want to bet that these "dental fees" include all the money spent on newer cosmetic dental procedures; veneers, whitening, caps, etc.

  • Zach

    Why should I have to go to a dentist to get my teeth cleaned, given that the person who cleans my teeth isn't a DDS? I don't have to go to an MD to get a massage, my hair cut, or a flu shot, nor to give blood. Hell, even EMT's aren't doctors.

  • Larry Sheldon

    I don't go to the dentist to have my teeth cleaned. (I do go to the dentist's office suite where is provides space for several "Dental Hygienists", one of whom cleans my teeth.

    Sometimes I just get charged for "cleaning", sometimes she also does X-RAYs so I get charged for that, I usually get the fluoride thing which is an extra, and usually the dentist looks me over but I think that is part of the "cleaning" thing.

    An acquaintance has saved a bunch of money by not going to the dentist at all for quite a while.

    Lots of teeth might be lost as a result. but hey, this is a free country--don't want to pay for a dentist, don't.

  • Pieter

    You ask "By the way, how did they figure a 100 million don't have 'access'?". I'd assume that they're refering to the roughly 100 million people with untreated cavities.

    I suppose you might say that they have 'access' to dental care, they just choose not to receive it. That's like saying I have access to cross-country flights and the right not to show ID to government officials; I just have to choose which I want.

  • Kyle Ressler

    This article is correct in that there are too many individuals throughout our country who do not have access to oral health care. On the other hand, it is an uneducated and ignorant to state that "there are not that many things in your mouth that can go wrong that will be bankrupting." It is obvious that this article's author has no history in formal dental education, nor have he/she ever visited a dentist for oral complications beyond the common cavity or scheduled cleaning. For example, proper treatment of cases involving multiple "crowns" or "root-canals" can cost thousands of dollars. In that case, it would be worth the money to purchase dental insurance.
    Also, the comment about Dr. Nash accepting a salary for serving as a professor is rude and beside the point. Personal Advise for future articles: have concrete knowledge on the subject at hand before your fingers touch the keyboard.

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