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My View: Are the teeth not part of the body?

April 23, 2012

By Michelle C. Dziurgot, D.D.S.

Last fall, as all general dentists do before the end of the year, I contacted my unscheduled patients reminding them to use their remaining dental benefits before the clock struck midnight on New Year’s Eve. Most scheduled but others declined, opting to wait until 2012 when their benefits renewed.

The most interesting emailed reply was from a patient with $900 of remaining 2011 dental benefits, who still needed to wait until 2012. Her reason was her cat. Her cat requires expensive iodine therapy at the vet. She had to decide on paying the vet or paying her 50 percent copay for her crown in November. She wrote in her email that dental insurance should be like medical: once the deductible is met, it pays 100 percent. She continued by questioning: "Why do the two insurances have to be separate? Are the teeth not part of the body? If a bad gum causes infection to travel to the heart, isn’t that then a medical issue anyway? Apparently, the insurance companies do not agree with me."

Wow, was her email an eye-opener for me. Our patients are responding to the promotion of "Want a Healthy Body? Start with a Healthy Mouth," but the division of medical and dental has led to disparities between the two.

I remember as a dental student being told by medical students that we were not going to be "real" doctors; just teeth docs. Funny, who do these "real" docs see when they need a root canal? As I waited to be seen today by an orthopedic surgeon, I was reading the latest article on premed for joint replacement in the Journal of the American Dental Association. Funny how the writer’s conclusion was "the 2009 AAOS Information Statement on antibiotic prophylaxis for people with prosthetic joints should be reconsidered."

And let’s not forget to mention the Michigan Dental Association’s December 2011 journal cover story on blood pressure. I remember a patient walking out on my hygienist after refusing to have her blood pressure taken. Funny how it was being taken as a precaution before beginning a two-hour scaling and root planning appointment.

If most of the population does not think of us as doctors, protecting the health and quality of their lives, why would insurance companies? We ideally treatment plan but are continually asked to opt for other, less costly treatment when the insurance denies a preauthorization. When we move forward with treatment and are denied by the insurance company, we jump through hoops to send in X-rays, photos and narratives to avoid billing our patients. Why do dental insurance companies treat their subscribers so callously? I understand everyone deserves to make a profit, but at what cost? A waiting period of six months in today’s economy can lead our patients to make very poor decisions on their dental treatment.

I loved being in the U.S. Navy. I could do any dental treatment I felt necessary as long as my sailor or marine showed up to their dental appointment. Why is dental insurance so backwards? Is it punishment for a poor diet, oral hygiene or socioeconomic background? It is not fair that the more dental treatment needed, the less benefit remains to fund it. Even our auto and homeowners insurances provide a better benefit than dental. If we get rear-ended, Allstate’s motto is "You’re in good hands."

Our patients are in good hands with us as their dental providers, but until dental and medical insurance merge and work as one, providing for their health and quality of life is compromised at best.

Dr. Dziurgot is the editor of the Journal of the Macomb Dental Society (Michigan). Her comments, reprinted here with permission, originally appeared in the winter 2012 issue of that publication.