Those BAAAAD poor dental patients are the REAL problem, doncha know...

[bobbolink]

Dental Clinics, Meeting a Need With No Dentist
By ALEX BERENSON
New York Times Published: April 28, 2008

UNALAKLEET, Alaska — The dental clinic in this village on the edge of the Bering Sea looks like any other, with four chairs, a well-scrubbed floor and a waiting area filled with magazines.

But to the Alaska Dental Society and the American Dental Association, the clinic is a place where the rules of dentistry are flouted daily. The dental groups object not because of any evidence that the clinic provides substandard care, but because it is run by Aurora Johnson, who is not a dentist. After two years of training in a program unique to Alaska, Ms. Johnson performs basic dental work like drilling and filling cavities.

Some dentists who specialize in public health, noting that 100 million Americans cannot afford adequate dental care, say such training programs should be offered nationwide. But professional dental groups disagree, saying that only dentists, with four years of postcollegiate education, should do work like Ms. Johnson's. And while such arrangements are common outside the United States, only one American dental school, in Anchorage, offers such a program.

(snippage)

"I'm not in favor of training just to fill teeth, because a solution of filling teeth is not going to reduce disease," he said. "The patients will go home, and they will drink six cans of soda a day, and they will come back with more cavities."

http://www.nytimes.com/2008/04/28/business/28teeth.html?pagewanted=1&_r=1

You see, it's all very simple... poor health is all the fault of poor folk.

So, just withdraw ALL treatment, because, of course, it does no good to treat poor people anyway.

We just won't talk about all the muddle-class and wealthy people who are non-compliant patients, or (gasp) drink soda.

Damned good thing there isn't a double standard in this country.

:argh:

[truedelphi]

1. I have had so many bad dentists in my life

The last dentist I had was so good in terms of his procedures and protocols but refused to give any pain meds so I had to tough out being in pain for 3 long weeks.

[Warpy]

2. Dontcha just love these elitist assholes?

People in my area drive 5 hours to see dentists across the border in Mexico. Local dentists have just priced themselves out of the market for people who aren't fortunate enough to have dental insurance, meaning most of them. Dental emergencies mean just toughing it out until Friday night and an overnight drive to the border.

Genetics and some disease processes also affect dental health. It's not just lifestyle, which these idiots would know if they hadn't slept through most of the lectures on the etiology of dental problems instead of saving their energy for the lectures on lucrative cosmetic procedures.

Poor dental health can kill. Bacteria from abscessed teeth can spread through the bloodstream to heart and brain. Poor dentition and dental pain can cause people to stop eating, weaken, and die.

Paraprofessionals are the best hope working people have: paralegals for legal matters, nurse practitioners and physician assistants for health matters, and basic dental practitioners for everyday dental problems.

Just expect fully accredited professionals to bitch and moan every step of the way.

[Mojorabbit]

10. I still think they should be overseen

like a nurse practitioner is. A patient could go home and develop an infection that needs treatment for example or have a raging sinus infection showing up as tooth pain. Otherwise it is a great idea.

[uppityperson]

12. Some NPs are able to practice independently. Some with supervision.

It depends on the licensure and the state I believe. Scope of practice can say totally independent, depending on education and license and state.

[nichomachus]

16. On the other hand

take away this person and all of the above will still happen -- plus the patient's cavities won't get filled. Some care is better than no care.

[sandnsea]

14. Our PA's and Practitioners cost the same

They aren't cheaper at all. The fees are exactly the same as the doctor's fees. The clinic isn't set up to send simple cases to the PA's. In fact, our best diagnostician sees the daily sick cases. I don't have a problem with paraprofessionals, but they aren't being used the way we were told they would be, at least not in the medical profession.

[Patchuli]

20. You are right!

And those elitist assholes can just bitch and moan all they want...until they make dentistry available to all, people will do whatever they have to keep their teeth. Too bad all health professionals don't go in it to serve the health of the people instead of their own pocketbooks.

[caseycoon]

3. "Let them eat cake"

So their teeth can rot faster!
:sarcasm:

**Some dentists who specialize in public health, noting that 100 million Americans cannot afford adequate dental care, say such training programs should be offered nationwide.**
This is a WONDERFUL idea. DAMN the dentists who don't want it implemented & prefer that folks go without dental care because they can't afford it!
:grr:

[bobbolink]

5. I love your gallows humor. I think. ^_^ This double-standard crap must END!

It's just NEVER true that affluent people, who can afford dentists, don't take proper care of their teeth, and drink soda, right??

Let the damned ADA eat the cake!

Then, withhold treatment!!

COMMA!!!

:hug:

[uppityperson]

4. I read it as don't just fill teeth but educate people also.

Alaska has some interesting programs, tiered care. I hadn't heard about this one, thanks for posting the article.

Bit about training, what they can do, supervision:
"After two years of intensive training, the therapists are allowed to perform routine tooth extractions and fill cavities. They must refer more complicated cases, like root canals and complex extractions, to dentists. They must also work under the supervision of a dentist, who reviews their work either in their clinics or off-site, by electronically vetting documents and X-rays."

Here is the bit about education that I agree with:
"But the aides will not be trained to drill and fill teeth. In the long run, the only way to improve dental health is encourage people to take better care of their teeth, Dr. Ismail said."

And here is the bit about access and affordability I agree with:
"But the therapists and their supporters say the A.D.A.’s program will do little to solve the overall problem of access for people who have untreated cavities and cannot afford to pay the fees that dentists charge — because there simply are not enough dentists who will take Medicaid patients or provide low-cost treatment for patients who cannot afford more."

ALL dentists should be educating their patients.

[ccinamon]

6. I don't recall a dentist ever saying anything to me about preventing disease...

it's the dental hygenists who get to tell the patients to brush better and floss more...

I have VERY sensitive gums and can't get a dentist to knock me out before working on me...so I stopped going...just can't stand the pain...every year it gets worse and the dentists I have been to don't seem to care.

Next time I go to the dentist it will be probably to pull any damaged/infected teeth...no more root canals or crowns for me...after years of grinding my teeth (when much younger), my teeth split and crack when they try to "fill" a cavity, so repair is pointless.

[bobbolink]

8. At least you get to go to a dentist. If you want.

Excuse me, but this thread is about people who are DENIED treatment because they're poor.

Isn't that a "liberal" and "progressive" issue?

[knitter4democracy]

19. It took me awhile to find a good one who deals with my pain.

I can't do narcotics or some numbing agents, so he works out what I can use and actually waits for the stuff to take effect. Best guy I've ever had, but I have to save up to see him (no dental with Hubby's new job).

[Blue_In_AK]

7. The thing that's so really stupid about this

is that none of the dentists actually want to go out and LIVE in the villages, and you certainly can't drive to them, but still they want to prevent the paraprofessionals from living and working and helping the villagers who have no other recourse. It's very similar to the obstacles that home-delivery midwives have faced over the years. Professional jealousy is a terrible thing.

ed. They don't mention that for someone out in Western Alaska, say, to fly in to Fairbanks or Anchorage to see a dentist costs about $400 round trip, so add that to the actual cost of the dental visit, and it becomes truly prohibitive.

[bobbolink]

9. "Professional jealousy"... and complete disregard for poor folk!

This is making me ILL!!!

Does this affect people around where you are?

[Blue_In_AK]

15. No, I'm in Anchorage

and there are plenty of dentists here in town -- although I haven't been to one for years because I can't afford it. I don't believe any of these paraprofessional dentists are here in the city. The program has mostly been geared to the small Native villages where there is NO dental care whatsoever. It's very, very sad to see the condition of the kids' teeth out there. From what I understand, the Native people used to have very strong teeth with no dental problems until the introduction of the "American" diet which has just wreaked havoc (along with a lot of other American vices ... alcoholism, most particularly) on the rural population.

Rhonda McBride, a former reporter at KTUU here in Anchorage, ran some excellent stories on this dental therapist program last year. Links to her stories are here:

http://www.ktuu.com/global/story.asp?s=6596429&ClientType=Printable

http://www.ktuu.com/global/story.asp?s=6601510&ClientType=Printable

The video that went along with this showing the deplorable conditions of the people's teeth out there was just heartbreaking.

[raccoon]

11. Rec'd. If sodas/sweets were the only cause of cavities, I wouldn't have

fillings in all my molars.

As someone else said, a lot of it is genetics. And some people's teeth are just more likely to get cavities than other people's.

[bobbolink]

13. Thanks for the rec! I thought there'd be more for this. It is SO WRONG!

Yet so many people will read this (front page of NYT) and nod their heads in agreement.

Those damned, awful, lazy poor people!

What does it take to raise the level of awareness????

Thanks again for your rec!

[cbayer]

17. I don't know if you saw this yesterday

but I thought you might be interested:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x3214605

[bobbolink]

24. Excellent post! Thank you very much for that article!

This is soooo wrong, and it's time we all made a HUGE fuss about this!

Thanks!

[knitter4democracy]

18. So, she's like a dental PA? What's the problem?

Doctors have Nurse Practitioners and Physician Assistants who do a lot of the usual stuff, leaving the harder, more complicated stuff that takes an MD to the MDs. So, now it's the dentists' turn, and they don't like it? That's small-minded, stupid thinking. There's a need, the DA is filling it, and people are getting care.

Honestly, they need to get their heads drilled out of their asses on this one. Their disrespect for the poor is disgusting, and their hatred of any and all lost billing--even where there isn't a dentist to meet the needs of the people--is disheartening.

[G_j]

21. I have innately vulnerable teeth

I never was that big on soda or sweets like many kids growing up. I had many cavities and serious problems.
My brother had a sweet tooth, ate all kinds of bad stuff, and had no cavities.

"I'm not in favor of training just to fill teeth, because a solution of filling teeth is not going to reduce disease," he said. "The patients will go home, and they will drink six cans of soda a day, and they will come back with more cavities."


The above statement is absurd. The guy is actually advocating denying dental care to children who can't afford it.
He is just scrambling for a justification for putting money before people.
What a jerk!

[knitter4democracy]

22. I'd agree with all of that.

My son was born with a couple of molars coming in without enamel all the way around. He could've never eaten a single bit of sugar and still needed major dental work. That guy's all about the money.

[bobbolink]

23. "The guy is actually advocating denying dental care to children who can't afford it."

to EVERYONE who can't afford it! In the richest country in the world!

You know, several of us here have punched holes in he scenario, yet what will happen is the ADA will deny dental care to so many of us.

This is just

EVIL!