Impressions
“ Our rotten dental care system : If you ’ re poor , just grin and bear it …”
Did I get your attention ? Because the above headline caught my attention . It came from an op-ed piece written by Dr . Frank Huyler and printed in the New York Daily News on Sunday , May 15 . I don ’ t regularly read the N . Y . Daily News , but I do constantly trawl for dental news and this popped up the Monday after it appeared in the newspaper .
In the op-ed , Dr . Huyler , an emergency room physician , related a recent event in his life . Bothered by a toothache for several days , he made his way to the office of an endodontist in New York City . He liked the office and the endodontist very much . He felt comfortable and well cared for . The appointment was quick , only 30 minutes , and painless , according to Huyler . His treatment cost $ 1,200 , part of which was covered by his dental insurance .
So why would he write an article for publication that says , “ That is why the teeth of the poor are so bad . It ’ s why the profession of dentistry in the U . S . is an ethical disgrace ”?
An ethical disgrace ? Every day , Huyler writes , he sees poor patients that walk into his emergency room with a toothache . They come to the ER , according to him , because they have nowhere else to go . They don ’ t have dental insurance and they can ’ t afford to pay out of pocket for treatment . The best he can do for them is to give them pain medication , antibiotics and refer them to a community clinic . He goes on to say that when they get to the clinic , restorative treatment is usually out of the question and an
D r . B r u c e R . T e r r y
extraction is the only alternative . His conclusion is that the dental community is grossly neglecting the poor . Either dentists don ’ t treat the poor at all , or they provide minimal services at best .
Is that a fair statement ? Dr . Huyler says that he is lucky to have a professional career and dental insurance , so a root canal is no problem for him financially . But , if you are unlucky enough to have no job or a low paying job and no dental insurance , then comprehensive dental care is out of the question . If faced with the decision to pay rent or buy food or see a dentist , Huyler says that dental care is not an option .
In fairness to Huyler , his opinion piece was meant to challenge the Republican budget plan put forth by Rep . Paul Ryan . According to Huyler , the plan calls for a retooling of Medicare that will more or less resemble the dental insurance payment system . In reality , Ryan is suggesting a voucher system for those under the age of 55 that would replace the current Medicare system ( the plan makes no changes for those 55 and older ). Huyler wants others to understand that a vote for the Ryan budget cuts will be a vote for a vastly less robust Medicare plan . Medicare patients will be faced with higher out of pocket expenses that will force many to make hard choices just like the dental patients that walk into his ER .
Today we are faced with many challenges . Moral , financial and health issues clash to form the perfect storm of controversy . While some patients don ’ t visit the dentist because of a general fear , many just can ’ t afford dental care . Even if dental care was free to everyone , many would still avoid the dentist at all costs and show up only when the problem is at its worst . Statistics have shown that even when Medicaid pays the bills , only a small percentage of eligible patients actually take advantage of the program . Promoting better eating habits , dental hygiene and fluoride should be lowering the rate of dental decay in this country , but a recent CDC report showed that dental disease is on the rise in children for the first time in 40 years .
Organized dentistry is trying to help . Volunteers give thousands of hours and millions of dollars of donated dental services each year .
Dr . Huyler thinks that our offices are charging an excessive fee for our services . He singles out dentistry but then also takes a poke at $ 2,000 endoscopies and colonoscopies . He sees greed in all of health care but he calls only dentistry an “ ethical disgrace .” Since he works in a hospital as an
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July / August 2011 • Pennsylvania Dental Journal
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