The real question is not why is dentistry kept separate from medicine. The real question is why dental insurance is treated like a luxury, compared to regular health insurance. The problem is that so many people are unable to afford dentistry, because of poor or no coverage.
If you have a type of expense that's (a) unpredictable, and (b) rare, then it's a good fit for insurance.
Car crashes are unpredictable and rare, so it makes sense to insure them.
Regular car maintenance is predictable and tends to happen in (almost?) every insurance period, so it's not - some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly because of an extra middleman.
Getting a broken leg or cancer is unpredictable (there are individual risk factors, but they are just as relevant for car crashes) and rare, so it makes sense to insure them.
Dental care, on the other hand is common and regular - e.g. someone who didn't have coverage for broken leg or cancer most likely won't get a broken leg or cancer in the next year, but all the people who have been unable to afford dentistry generally almost all will need dentistry in the next year. Some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly because of an extra middleman. If you are unable to afford dentistry, then you'd be unable to afford the insurance price hike.
It's not a problem of insurance as such, it's a problem of who pays for healthcare of poor people. USA has a weird historical artifact in that in the last >100 years insurance has become almost a synonym for employer-funded healthcare payment plans, not as real insurance. If you want employer-funded healthcare to include dentistry, then that's not going to be solved by medical people but the employment market - industries where workers have market power (e.g. IT) will get such conditions, and industries where worker's don't have market power (e.g. fast food) won't. Also, this can't solve the manner of dentistry for unemployed or underemployed people who don't get employer-funded insurance and thus a dentistry-included insurance would be as expensive or more than just paying for a dentist.
Dental insurance isn't even really insurance so it isn't comparable to medical insurance since there are no out of pocket maximums and the maximum benefit is pathetically low. It's basically a dental care/maintenance subscription and if you need any major work, you're going to pay $$$.
Dentist here , I agree that many people can't afford desired treatment. It's common occurrence in a Dental office. Having the insurance still makes one liable for deductible ( entry money to seek any treatment ) , co payments and other hidden costs . That's how the system is designed.
Dental/oral health is crucial. You can die from dental problems. I will never understand why the entire dental industry is treated as if it is cosmetic or non-essential. Stress to your immune system and failure of major organs is not taken seriously, but it is a very real risk.
Recently there was a case of a woman having to undergo brain surgery after bacteria from an untreated tooth attacked her brain. She's now learning to walk again.
NHS Dentistry in England and Wales is one of the biggest hidden scams yet to be revealed. The 'Unit of Dental Activity' scheme encourages dentists to delay treatment unnecessarily to cover their basic costs. The sooner the UK government acknowledges that the current NHS Dentistry setup is not sustainable, the better it will be for all.
Dentists in the UK receive a bachelor degree, as do doctors.
However it was a sanctionable offence in the eyes of the General Dental Council for a dentist to title themselves Dr.
This was purely a Dental Council regulation, anyone at the time could call themselves doctor, it wasn't a criminal offence.
With the arrival of dentists from EU countries who were allowed to do so, UK dentists felt they were being put at a disadvantage in the eyes of the general public.
The GDC eventually relented with an announcement to the effect that dentists doing this would not be taken action against any longer.
In Greek the equivalent to "dentist" is "odontiatros" which translates exactly as "tooth doctor". So for me a dentist not regarded as doctor sounds extremely weird.
i'm very happy its under a separate umbrella. think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level.
currently it costs 150$ to show up 10 minutes early for an appointment to be seen 20 minutes late for an interaction that lasts 5 minutes. and then i say 'my knee also hurts' and they say you need to schedule another appointment if you want to discuss any other ailments. insurance covers 100$ of that, but I am under no illusion of the cost.
do we need to raise dental awareness? sure. do we need to put it under the bureaucracy and price fixing of the medical system? i dont think so
> think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level.
That seems more an indictment of the medical education system than the insurance system. There are already parallel medical education systems in the US (MD vs. DO, although there is little practical difference). Seeing either type of physician is treated equally by health insurance. Why can't health insurance also cover DDS visits as well?
Most dentists won't even need additional education - after all, we are actually just trying to get what they do covered. It doesn't mean the system or education must change, and in practice it will be like going to a specialist without having to visit the GP first. You wouldn't complain to the gastric specialist that your knee hurts either.
The bigger changes would be in health insurance coverage and things like that. Basic cleanings are more likely to be cheap: extractions might wind up costing more if one must pay their deductible first. Sure, some of the services will continue to be cosmetic only - but plastic surgeons (who often also do reconstructive surgery along with complicated dental extractions) seem to manage this just fine.
You being seen on time isn't an issue with this, honestly. Some doctor's offices have a habit of being on time. You can let them know upfront that you have multiple issues as well - this allows them to schedule more time with you (and bill insurance accordingly).
> the bottle necks they would put up to raise the wages to MD level.
Dentists can easily make more money than the majority of physicians. Not to mention they don't have a residency, my few dentist friends came out of dental school at 26 making 150k+.
Do the math and you'll find dental insurance is a ripoff. Additionally, while some people can't afford much of anything, others who complain about the cost of dental care, buy things as or more expensive because they value those things more: Big screen TV for example. They don't value dental care as much, until they are in pain. Then they expect an entitlement. People pay for what they want. Dental insurance is a subsidy, not insurance. Delta Dental of CA has over $600,000,000 invested in tradable securities. They didn't pack away that much money giving away dentistry for free.
Delta Dental of CA has over $600,000,000 invested in tradable securities - all from your premiums paid to them with a piddly $1000 annual maximum with absurd limitations. I agree. It is a scam.
Also, all this was done in a very unsanitary way. In fact medicine was unsanitary in the West until Florence Nightingale conducted an statistical survey showing that cleaner spaces had fewer mortality rates.
I just saw this week an endocarditis due to the lack of dental hygiene. None of us was properly trained to evaluate if the patients​ teeth were ok. Shame. Dental health is not even available in lot of public health system like the Spainish one. I'll never understand why it's treated differently.
Break a tooth on a Friday night and need dental work? You think, I will goto the ER and they can help. Nope, they will just give you medicine to deal with the pain until you can see your dentist on Monday morning. I am not aware of a ER in the DFW area that has a dentist on call.
Make sure to poke a very thin wooden stick regularly (daily, before bed, after brushing) between your teeth and marvel (or be disgusted) at the amount of plaque that comes out which you missed by just brushing -- honestly it's an insane amount.
better than wooden sticks and flossing are the interdental brushes. Those clean a lot better in my experience and my oral health improved a lot after i started using them.
I was thinking of pharmacists. They are sorta kinda doctorish (they even get Doctor of Pharmacy degrees), but not really. They are supposed to be consulted by doctors as the prime authority on medications, but this seems to rarely happen outside of hospitals. Doctors most likely think they know enough about the medications they prescribe to not need regular help.
Oh, and what about podiatrists? Health care seems sufficiently splintered that I would have never wondered why dentistry is separate.
In Italy, until the 1980 dentists were medical doctors that decided to specialize in dentistry. It's still the case for a large part of them. But now there are separate schools.
Despite the article's pretence this is some universal historical wart, I take it this is an American foible, another artefact of the arcane clusterfuck that is US healthcare?
In the U.K., dental care is available on treated on the NHS just like other forms of care.
All non-emergency health in the UK is mediated via your GP. Except dentistry. All expert medical procedures in the UK will be carried out by an MD, no matter what part of your body they're on. Except for your teeth. For any serious medical treatment in the UK that requires anaesthesia, or surgery, you are likely to be treated at a general hospital which happens to have an appropriate unit. Except ... dentistry, where they have specialist dental hospitals.
Finally, treatment on the NHS for all medical conditions is free at point of use, except for prescriptions. Except dentistry, which is merely subsidised, and generally provided by dentists who work privately, and offer to provide slightly different treatments on the NHS than they do privately.
There is still a divide in the UK - unlike general medical care, dental care is not 100% free at the point of use (Similar for optical care).
Dentists can take a mix of private and (public) NHS patients or specialise purely in private or NHS. If you move to a new area it can sometimes be hard to get into a practice as an NHS patient.
Typically, if I get a check up and need nothing done other than scale and polish the cost is around 15 USD (The exam part being free)
As a consequence, having some dental insurance plan is not uncommon here - my partner needs more dental work than I do so has such a plan called Denplan.
It is technically available but it isn't universally free and most people who have a choice elect for private treatment anyway. NHS dentistry in the UK has a very bad reputation, mostly deserved.
In France and in Italy they are formally treated as a whole, but in practice they are two separate worlds. In particular, financial coverage in France and availability in public structures in Italy are very different between "dentists" and "doctors".
In Sweden, dental is treated separately. There are public dentists, but they're only free of charge up to age 19, and after that there are only a couple rebates available (IIRC the government will pay 30% of procedures over a certain cost, and every other year you get a check that covers one checkup)
In Japan, basic dentistry is covered the same under national health insurance, but for instance if you want a ceramic crown instead of metal, you have to pay for that yourself. Dentists and general medicine are completely separate institutions though.
I don't see the article claiming universality outside the US. But in many European countries, dentistry is indeed largely or completely separate from the rest of medicine.
mtdewcmu|9 years ago
PeterisP|9 years ago
Car crashes are unpredictable and rare, so it makes sense to insure them.
Regular car maintenance is predictable and tends to happen in (almost?) every insurance period, so it's not - some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly because of an extra middleman.
Getting a broken leg or cancer is unpredictable (there are individual risk factors, but they are just as relevant for car crashes) and rare, so it makes sense to insure them.
Dental care, on the other hand is common and regular - e.g. someone who didn't have coverage for broken leg or cancer most likely won't get a broken leg or cancer in the next year, but all the people who have been unable to afford dentistry generally almost all will need dentistry in the next year. Some payment plan or bundling may be an option, but insurance makes no sense, it would only be more expensive than paying directly because of an extra middleman. If you are unable to afford dentistry, then you'd be unable to afford the insurance price hike.
It's not a problem of insurance as such, it's a problem of who pays for healthcare of poor people. USA has a weird historical artifact in that in the last >100 years insurance has become almost a synonym for employer-funded healthcare payment plans, not as real insurance. If you want employer-funded healthcare to include dentistry, then that's not going to be solved by medical people but the employment market - industries where workers have market power (e.g. IT) will get such conditions, and industries where worker's don't have market power (e.g. fast food) won't. Also, this can't solve the manner of dentistry for unemployed or underemployed people who don't get employer-funded insurance and thus a dentistry-included insurance would be as expensive or more than just paying for a dentist.
fav_collector|9 years ago
brianwawok|9 years ago
Get cancer? That could be a million dollars in treatment. You need insurance.
Get a bad tooth? Maybe 3k max to replace it with a bridge or similar.
The idea is most people can scrouge up 3k but not a million bucks.
drcnyu555|9 years ago
rebootthesystem|9 years ago
Fire-up Excel and develop a financial model for providing dental insurance to a million people.
On another tab, develop a financial model for providing mid-range health insurance to a million people.
Finally, develop a financial model for providing automobile insurance to a million people.
This will answer all your questions.
BecuzYoullLive8|9 years ago
[deleted]
feld|9 years ago
dsego|9 years ago
badly translated article https://translate.google.hr/translate?sl=hr&tl=en&js=y&prev=...
wslh|9 years ago
10dpd|9 years ago
barking|9 years ago
This was purely a Dental Council regulation, anyone at the time could call themselves doctor, it wasn't a criminal offence.
With the arrival of dentists from EU countries who were allowed to do so, UK dentists felt they were being put at a disadvantage in the eyes of the general public.
The GDC eventually relented with an announcement to the effect that dentists doing this would not be taken action against any longer.
But they clearly didn't approve!
partycoder|9 years ago
unknown|9 years ago
[deleted]
kilon|9 years ago
autokad|9 years ago
currently it costs 150$ to show up 10 minutes early for an appointment to be seen 20 minutes late for an interaction that lasts 5 minutes. and then i say 'my knee also hurts' and they say you need to schedule another appointment if you want to discuss any other ailments. insurance covers 100$ of that, but I am under no illusion of the cost.
do we need to raise dental awareness? sure. do we need to put it under the bureaucracy and price fixing of the medical system? i dont think so
mivade|9 years ago
That seems more an indictment of the medical education system than the insurance system. There are already parallel medical education systems in the US (MD vs. DO, although there is little practical difference). Seeing either type of physician is treated equally by health insurance. Why can't health insurance also cover DDS visits as well?
Broken_Hippo|9 years ago
Most dentists won't even need additional education - after all, we are actually just trying to get what they do covered. It doesn't mean the system or education must change, and in practice it will be like going to a specialist without having to visit the GP first. You wouldn't complain to the gastric specialist that your knee hurts either.
The bigger changes would be in health insurance coverage and things like that. Basic cleanings are more likely to be cheap: extractions might wind up costing more if one must pay their deductible first. Sure, some of the services will continue to be cosmetic only - but plastic surgeons (who often also do reconstructive surgery along with complicated dental extractions) seem to manage this just fine.
You being seen on time isn't an issue with this, honestly. Some doctor's offices have a habit of being on time. You can let them know upfront that you have multiple issues as well - this allows them to schedule more time with you (and bill insurance accordingly).
dikdik|9 years ago
Dentists can easily make more money than the majority of physicians. Not to mention they don't have a residency, my few dentist friends came out of dental school at 26 making 150k+.
dmersky|9 years ago
qrbLPHiKpiux|9 years ago
partycoder|9 years ago
https://en.wikipedia.org/wiki/Barber_surgeon
Also, all this was done in a very unsanitary way. In fact medicine was unsanitary in the West until Florence Nightingale conducted an statistical survey showing that cleaner spaces had fewer mortality rates.
merqurio|9 years ago
bigtex|9 years ago
Rainymood|9 years ago
vinay427|9 years ago
7sigma|9 years ago
ar-jan|9 years ago
Before brushing, I'd say. Then the fluoride in the toothpaste can better reach between the teeth.
pjc50|9 years ago
peteretep|9 years ago
mtdewcmu|9 years ago
Oh, and what about podiatrists? Health care seems sufficiently splintered that I would have never wondered why dentistry is separate.
maxerickson|9 years ago
An optician designs lenses and fits glasses.
ekianjo|9 years ago
kome|9 years ago
jonwachob91|9 years ago
drcnyu555|9 years ago
qrbLPHiKpiux|9 years ago
grabcocque|9 years ago
In the U.K., dental care is available on treated on the NHS just like other forms of care.
peteretep|9 years ago
All non-emergency health in the UK is mediated via your GP. Except dentistry. All expert medical procedures in the UK will be carried out by an MD, no matter what part of your body they're on. Except for your teeth. For any serious medical treatment in the UK that requires anaesthesia, or surgery, you are likely to be treated at a general hospital which happens to have an appropriate unit. Except ... dentistry, where they have specialist dental hospitals.
Finally, treatment on the NHS for all medical conditions is free at point of use, except for prescriptions. Except dentistry, which is merely subsidised, and generally provided by dentists who work privately, and offer to provide slightly different treatments on the NHS than they do privately.
rollthehard6|9 years ago
Dentists can take a mix of private and (public) NHS patients or specialise purely in private or NHS. If you move to a new area it can sometimes be hard to get into a practice as an NHS patient.
NHS dental care is heavily subsidised but not entirely free (See here for prices where I am in Scotland - https://www.scottishdental.org/public/treatment-charges/)
Typically, if I get a check up and need nothing done other than scale and polish the cost is around 15 USD (The exam part being free)
As a consequence, having some dental insurance plan is not uncommon here - my partner needs more dental work than I do so has such a plan called Denplan.
_nalply|9 years ago
As one can imagine some grey areas can make it difficult to determine whether a dentist treatment is covered or not.
dazc|9 years ago
pif|9 years ago
vacri|9 years ago
kalleboo|9 years ago
In Japan, basic dentistry is covered the same under national health insurance, but for instance if you want a ceramic crown instead of metal, you have to pay for that yourself. Dentists and general medicine are completely separate institutions though.
halflings|9 years ago
gpvos|9 years ago
unknown|9 years ago
[deleted]
JetSpiegel|9 years ago
Aaargh20318|9 years ago