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Back to Reality
[Expansion of dental care uncertain under new administration]
Amid promises to overturn the health care reform law and re-engineer Medicaid, voters swept Republicans into power in November.
http://healthjournalism.org/blog/2016/12/expansion-of-dental-care-uncertain-under-new-administration/
Oral health advocates now are wondering what lies ahead for efforts to expand access to dental services to poor, working and uninsured Americans.
Mary
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Morale in dentistry drops (but don’t tell anyone)
“Morale levels in dentistry drop – Morale amongst self-employed primary care dentists in the UK has fallen, according to NHS Digital.” By Seb Evans for Dentistry.co.uk, December 8, 2016.
http://www.dentistry.co.uk/2016/12/08/morale-levels-in-dentistry-drop/
Evans: “A survey has found that the percentage of principal dentists with ‘very high’ or ‘high’ morale levels has dropped to 22% in England and Wales, compared with around 23% in 2013/14.”
Evans:
The more time dentists spend on NHS/health service work [think “managed care”] the lower their levels of motivation, according to the survey.
Half of all survey respondents said they often think about leaving general dentistry, despite 55% of respondents saying they feel good about their job and 57% saying they have the opportunity to do challenging and interesting work.
‘We’ve known for some time that dentists morale has been declining with many feeling that they are spending more time dealing with regulation and less time treating patients,’ Neel Kothari, practice owner, said. [Sound familiar?]
‘There is now unanimous agreement that NHS dentistry [managed care] is unfit for purpose resulting in higher levels of demoralised staff.
‘The NHS is a heavily budgeted system that seems to prioritise access over quality care, which makes it hard for dentists to practice in a way they were taught at dental school. [Sound familiar?]
‘Whilst over promising and under-delivering may work for the Department of Health [and dental “insurance” companies], this report shows that its clearly not working for caring, ethically-minded dentists.’
————————————————–
Here in the U.S., one would never read such discouraging news on Dentistry IQ – the upbeat, advertisement-friendly U.S. equivalent of Dentistry.co.uk.
I am certain almost all American dentists (quietly) agree that Evans’ description of “lower motivation levels,” describes the morale decline among preferred providers here at home as well. The difference is, leaders in the UK care enough about patient welfare to survey their contracted dentists’ concerns. On the other hand, conflicts of interest closer to home force our nation’s dental insurers to hide bad news from the public, and our equally-conflicted dental leaders don’t want to hear about it. It’s a good-ol-boy tradition that keeps revolving doors spinning at ADA Headquarters.
Either way, insured patients are never warned about compromises that give under-financed dentalcare bad names… like “Delta Dental” – one star rating on Consumer Affair. Read the complaints for yourself. Share them with dental leaders.
https://www.consumeraffairs.com/health/delta-dental-plans-association.html
Transparency now!
D. Kellus Pruitt DDS
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Researcherssee potential for teledentistry to address disparities in care
Telehealth technologies are on the rise, connecting patients and providers, and expanding access to crucial health services that can be scarce and sometimes difficult to reach.
Thanks to digital innovations, high-riskinfants and stroke patients are receiving specialty care remotely. People coping with anxiety and depression are benefiting from therapist-supported internet cognitive behavioral therapy.
In the field of oral health, teledentistry is proving increasingly useful too, according to the December issue of Health Affairs that explored the transformative potential of telehealth technologies.
https://healthjournalism.org/blog/2019/03/researchers-see-potential-for-teledentistry-to-address-disparities-in-care/
Melinda
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Officials ramp up warnings to delay most dental procedures
In carefully worded directives intended to slow the spread of COVID-19 and conserve protective equipment, government health officials are urging U.S. dental clinics to postpone most procedures.
Without personal protective equipment (PPE), even routine oral health services can easily expose workers and patients to transmission of a variety disease. Providers and patients are face-to-face; instruments used in the procedures generate droplets containing water, saliva, blood and microorganisms, as the Centers for Disease Control and Prevention (CDC) notes in new infection control guidelines for providing dental care during the COVID-19 emergency. But patients who have or may have COVID-19 present additional risks, according to the agency.
https://healthjournalism.org/blog/2020/04/officials-ramp-up-warnings-to-delay-most-dental-procedures/
Mary
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Dentists and COVID-19: We’re in trouble, Doc.
“Consistent Detection of 2019 Novel Coronavirus in Saliva”
Kelvin Kai-Wang To, et al, in Clinical Infectious Diseases, ciaa149, https://doi.org/10.1093/cid/ciaa149, Published: 12 February 2020
“The positive viral culture indicates that saliva contains live viruses that may allow transmission. Respiratory viruses are considered to be transmitted from person to person through direct or indirect contact, or via coarse or fine droplets. Saliva can be emitted through cough, and respiratory droplets containing influenza virus can be found even during normal breathing. Therefore, 2019-nCoV may be transmitted via saliva directly or indirectly even among patients without coughing or other respiratory symptoms. Our findings reinforce the use of surgical masks as a control measure.”
Though dentistry’s reticent leaders remain silent, this study implies that when dental offices re-open to routine care, aerosols originating in asymptomatic patients’ mouths will be created by dental handpieces, ultrasonic cleaners and air/water syringes.
If nobody speaks up quickly, dentists and staff will not be adequately protected. Don’t believe me? Sit back and watch them fall.
THIS MUST BE ADDRESSED.
Darrell Pruitt DDS
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Thank you for the quick response, ADA.
I read the disappointing “ADA Interim Guidance for MinimizingRisk of COVID-19 Transmission” you suggested. https://www.ada.org/~/media/CPS/Files/COVID/ADA_COVID_Int_Guidance_Treat_Pts.pdf?utm_source=cpsorg&utm_medium=cpsalertbar&utm_content=cv-pm-ebd-interim-response&utm_campaign=covid-19
ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission
Last Updated: 4/1/20 2 ADA Interim Guidance for Minimizing Risk of COVID-19 Transmission Visit ADA.org/InterimGuidance to view the three flowcharts detailing …
http://www.ada.org
I have bad news. I’m afraid that even if dentists follow the CDC recommendations to the letter – the costs of which will inevitably push routine care beyond the financial reach for even more Americans – it will not keep us safe. Dentistry’s unique and unavoidable aerosol production originating in patients’ mouths will cause dentists, staff and loved ones to be far more likely to catch the disease and die than anyone else in healthcare. As you know, superbly protected nurses and doctors are dying daily even without stirring up aerosols.
In spite of all the expense, within months of opening under the CDC guidelines, dental offices are certain to become known as places to catch COVID-19.
So what is plan B? Universal testing of staff and patients, perhaps? Any idea when fast, reliable testing kits will be available for the dental industry? I’ll wait. Otherwise, dentistry has simply become too dangerous for everyone.
Darrell K Pruitt DDS
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93% of Americans plan to visit the dentist in 2021
A new survey published by Delta Dental on American’s oral health behaviors during the COVID-19 pandemic finds:
• 90% of Americans believe that during the pandemic, maintaining oral health is essential to protecting their
overall health
• 72% of Americans are paying closer attention to their oral care habits at home as a result of COVID-19
• 93% of Americans plan to visit the dentist in 2021
Source: Delta Dental, March 18, 2021.
Hank DMD
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