That’s essentially the question behind a story in the New York Times today about the state of the dental profession:
For middle-class and wealthy Americans, straight white teeth are still a virtual birthright. And dentists say that a majority of people in this country receive high-quality care.
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.
In some cases, the results of poor dental care have been deadly. A child in Mississippi and another in Maryland died this year from infections caused by decayed teeth.
The dental professions 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. Im a cynic about my profession, but the data are there. Its embarrassing.
A defender of the profession is Dr. Terry D. Dickinson, a practicing dentist who is also the executive director of the Virginia Dental Association. He says he believes that dentists are charitable and want to provide care to poor patients. But dentists are also in business; they must pay rent and employee salaries, and they deserve fair fees, he said.
Charity is not a health care system, Dr. Dickinson said.
Dentists, of course, are no more obligated to serve the poor than are lawyers or accountants. But the issue from a public health standpoint, the critics say, is that even as so many patients go untreated, business is booming for most dentists. They are making more money while working shorter hours, on average, even as the nations number of dentists, per person, has declined.
The article seems to have struck a nerve — it’s currently the most emailed story on the NYT site.
-Greg Dahlmann