Over the past few years, the health care debate has dominated American politics more than perhaps any other issue. For evidence, look no further than the 46-and-counting separate votes the House of Representatives has taken to repeal the recent health care reform. Partisan divides have further split an already-polarized electorate and specific policy differences have made consensus impossible on almost every issue in and around the health care debate.
While both sides go at it over every minor detail, there is one point on which everyone can agree – our system for delivering health care is flawed, if not fundamentally broken. And while many of the system’s failures have been scrutinized ad nauseum by the media, how dentistry and dental specialties factor into the debate remains largely unknown.
Why is this factor overlooked? Many people see their Primary Care Dentist (PCD) with more frequency than they see their Primary Care Physician (PCP). And dental care is very closely connected with overall health in general. The practices that a patient undertakes vis-à-vis dental hygiene are often an indicator of their overall health and, in many cases, can predict complications that may occur in other parts of their body, like heart disease.
When people see their Primary Care Physician, they understand that he/she is not trained to perform every procedure or diagnose every disease. They know that while their PCP is certainly qualified to give them a physical, diagnose many illnesses, and treat them for a sinus infection, they probably wouldn’t ask him/her to administer anesthesia, remove a tumor or conduct a complicated coronary artery bypass surgery.
There are specialists for those types of treatments – specialists who have not only an advanced knowledge of the medicine, biology, and the treatments themselves, but who have also completed the requisite residency and advanced education to perform the procedures.
The same is true for PCDs and dental specialties, but many people don’t realize this because many state dental boards and PCDs put their own needs and interests ahead of what would be best for their patients.
While a Primary Care Physician wouldn’t attempt a brain surgery, many Primary Care Dentists are assuming the role of specialists without the qualifications or the training to do so. They apply braces (orthodontics), extract wisdom teeth (oral surgery), and perform gum surgery (periodontics). In some cases, they perform procedures on young children (pediatric dentistry), without informing parents that there are specialists more qualified for the job.
In addition to four years of dental school, each specialty practice requires the completion of an accredited, full time residency. A licensed pediatric dentist, for example, has also completed two additional years of residency training in dentistry for infants, children, teens, and children with special needs.
Let me be clear: not all Primary Care Dentists are guilty of these practices or out to deceive their patients. And not every state allows it. But certain states allow, and even encourage, this kind of behavior via an archaic and corrupt dental regulatory system.
Unfortunately, Arkansas is among them, and though my business is based there, other states are equally as guilty.
Since Arkansas has thus far refused to take action on this important consumer issue, raising awareness among individual consumers is crucial. Thus, I have launched a campaign on behalf of orthodontists and specialists nationwide to do just that.
This campaign, “I Choose My Smiles”, encourages consumers to know that their dentist may not be shooting straight with them about specialty procedures. Parents and consumers have a responsibility to know that while all orthodontists start as dentists before attending residency, Primary Care Dentists have not completed the residency to responsibly provide specialties.
When Primary Care Dentists claim to have the qualifications needed to perform advanced procedures, parents need to ask (and have a right to know) where they went to dental school, when they graduated, and what their class rank was. They should know whether they attended a full-time and accredited residency and whether they have a specialty license. And they should know that PCDs who are elusive about this information absolutely warrant further scrutiny.
To be sure, we have significant problems with our health care delivery and health insurance systems. These problems will take time to fix, and efforts to reform them from both sides are commendable. But when it comes to oral care by dentists and specialists alike, this fix should be one that all sides can agree on.
Burris owns the largest privately owned orthodontics practice in the country, headquartered in Fort Smith, Arkansas.