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Letters: More on dental visits

October 21, 2013

I would disagree with some of the points in Dr. Stephen Carter's letter (Sept. 16 ADA News).

Specifically, he seems to feel that the decline in dental visits is primarily due to people not having dental disease (fluoride, preventive intervention, etc.) I practiced for 40 years in a fluoridated community with a higher than average dental IQ and a higher than average percentage of insured patients, and it is my anecdotal opinion that dental disease is not dead. It is alive and well and thriving.

It is my opinion that people don't go for two reasons. It is expensive and it hurts. We need to think outside the box here. Everyone in public health seems to agree we have an access to care problem. I agree with Dr. Carter that training more dentists is not the answer because it addresses neither of the causes of declining dental visits. In other commercial enterprises, creating more supply should drive down prices, but in dentistry, with our $350-400K educations, that model does not apply.

So I would suggest a twofold approach. First, we need to make better use of auxiliaries (who earn auxiliary wages) to help drive down costs. Those of us with our pricey educations are spending a lot of time doing things that a technician could accomplish for a lot less money. We also need to drive down the cost of the education (I have no answers as to how). Making the visits more affordable would go a long way to increasing utilization.

Second, we need to focus more on prevention so we can eliminate the "hurt." Again, I don't have an answer as to how we get paid (and pay for our educations) for doing this.

We were told as students 40-plus years ago that caries would be wiped out in our lifetimes. That has simply not happened.

John Berk. D.D.S.
Castro Valley, Calif.