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Dentistry’s Discomfort Zone
June Thomas, a culture critic for slate.com, is fascinated with what she calls, “The American Way of Dentistry.” In 2009 she wrote her first dentistry-related article recounting her financial and emotional struggles to attain one of those Hollywood smiles that pervaded her new life in America and to repair the damage a lifetime of oral neglect had wrought. Thomas was born and raised in the industrial north of England where most adults over the age of 30 wore dentures and edentulism was considered inevitable. She didn’t even own a toothbrush until she was a student at her university in England. But by then, brushing had little positive effect on her decayed teeth.
As she tells it, her saviors were an American dentist and a job at Microsoft that offered dental insurance and a flexible spending account. Ten years and $45,000 in out-of-pocket expenses later, Thomas had pain-free teeth, could chew food with abandon, and most importantly could smile without embarrassment. But, after her ordeal, she began to wonder if others were living in the US suffering similar oral circumstances but did not have the money or time to spend on such an oral reclamation project. The quest to answer that question led her to research the current state of the American dental profession and those it serves.
Her latest article “Disrupting Dentistry,” published in January 2015 by slate.com, spotlights the access-to-care crisis for America’s poorest individuals, a topic that has been a hotbed of discussion in recent years and spurred an undercurrent of controversial solutions. The article focuses on Jeffrey Parker, CEO of Sarrell Dental, a nonprofit multi-site dental center in Alabama. Sarrell serves patients largely covered by Medicaid and the Children’s Health Insurance Program. Parker is not a dentist but rather a business management expert who served as a senior manager at General Foods, ConAgra, and Sara Lee before accepting a position with the business school at Jacksonville State University and then moving on to Sarrell. Sarrell’s well-paid dentists and staff treat as many as 100,000 patients per year and the experienced billing departments are well-practiced with processing the paperwork needed for quick reimbursement turnaround from government programs. When reimbursement dollar per patient plummets, Parker’s well-honed recruitment staff springs into action to increase patient volume. The corporate practice operates on a scale that private dentistry can’t hope to match.
But, as Thomas points out, it’s not just the poor who are challenged to meet their dental needs. Approximately 130 million Americans do not have dental insurance. For those with dental insurance, reimbursement rates don’t come close to covering the true expense of today’s dentistry, causing patients to delay treatment and possibly compromise their overall health.
It remains a complicated and difficult problem needing a solution…as uncomfortable as that solution may be.