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Letters: Dentistry's role in health care

January 05, 2015 I read Dr. Arnold Rosenstock's comments ("After-hours Emergency Care," Oct. 20 ADA News) regarding the self-limiting term "dental." It ain't just teeth. Before we can expect health care payers to view dental infections as medical emergencies we, as dentists, must first believe that we are treating pathophysiology that is connected to the entire health of our patients. Brookdale Hospital, during the Norman Cranin era (as Dr. Rosenstock mentioned), stressed to its residents that dentistry was an integral part of health care. Your stethoscope was used as often as your highspeed. The care of our patients was no more or less part of our patients health care than orthopedics or otolaryngology.

If we would like the medical complex to think of us as health care providers we must first think of ourselves as being part of the mainstream of health care.

Dentists often get locked into doing crowns and mesial-occlusal-distal restorations. We often lose sight of the fact we provide recommendations about issues that affect the general health of our patients on a daily basis.

The funding and reimbursement issues relating to the treatment of serious dental emergencies are partly about our perceptions of ourselves. These issues are also complicated by health insurance and government budgets.

The largest hospital in Rhode Island suspended its general practice residency training program beginning this year. I can only speculate that this is primarily due to financial concerns. I also believe it is partly due to how dentistry is perceived by the medical community. I am certain that many of the senior management at that hospital see dental training as an unnecessary afterthought and wonder why the hospital has a dental department at all.

Other disciplines have pushed and gotten reimbursements for care, such as chiropractors, optometrists, podiatrists and social workers. Clearly, we are seen as different.

The serious medical complications as well as the cost of treating these problems would be reduced dramatically if we were seen as vitally important to health care. Proper funding for this treatment would open access to care for most of these patients. In my state, Medicaid reimburses little for oral surgery. If you have Medicaid, good luck finding any one who will treat you.

Those same patients have access to primary medical care and the reimbursements are close to private health insurance.

It is up to dentistry to make the case for our role in health care. So far we have not done a good job at promoting our role or our importance. ADA could take a lead role in promoting this agenda.
Melvin Hanzel, D.M.D.
Warwick, Rhode Island