The Morning Drill: October 25, 2011

A collection of dentistry and health related links/comments for your day.

Is dentistry facing an ethical dilemma?

Scandals, lawsuits, a growing focus on commercialization and self-promotion, and dentists who prescribe excessive treatments are tarnishing the profession's image, according to a presentation on ethics at the recent ADA annual session in Las Vegas.

Most dentists may be surprised that a Google search on ethical scandals among health professions shows that dentistry now gets more hits than medicine, nursing, chiropractics, and pharmacology, according to Ann Boyle, DMD, interim provost and vice chancellor for academic affairs at Southern Illinois University.

Some of the public's changing perceptions toward dentistry can undoubtedly be traced to ubiquitous media coverage of scandals and malpractice lawsuits involving medical professionals, Dr. Boyle noted.

Gordon Christensen, DDS, MSD, PhD, discussed the decline of dentists' credibility in a 2001 article, noting a Gallup poll showed that their ranking among professions had fallen below nurses, physicians, and veterinarians (Journal of the American Dental Association, August 2001, Vol. 132:8, pp. 1163-1165).

Dentists were ranked third among the most trusted professionals in 1995 but slipped to ninth in 2001, according to Gallup poll rankings; they ranked sixth in 2009.

Negative influences, according to Dr. Christensen, included commercialization and self-promotion, excessive treatment and fees, providing service only when it's convenient, and refusing to accept responsibility when treatment fails prematurely.

Dr. Boyle recalled hearing from frustrated emergency room doctors who complained that they cannot adequately treat dental emergencies and said many patients come to them because no dentist will see them.

"We know there are reasons for this that MDs don't understand," she said, "but we must also realize that these front-line physicians consider us uncaring, selfish, and greedy and unprofessional and will tell anyone who will listen, including politicians."

SC Medicaid agency may reinstate dental coverage

South Carolina's Medicaid agency may reinstate paying for tooth extractions in 2012-13.

The state Department of Health and Human Services cut emergency dental service for adults last spring as it sought to close a $228 million deficit. Federal law doesn't require state Medicaid programs to cover dental service for adults.

However, the cut may actually be costing the state, if people with severe toothaches end up instead in hospital emergency rooms.

Agency director Tony Keck says the agency is negotiating with dentists, and a study is under way to determine whether cutting one program is shifting higher costs elsewhere.

Keck's budget request for 2012-13 says he may seek $3.7 million to reinstate the limited program, depending on the study's outcome. He says the analysis will take several months.

Many Young Children Off to a Poor Start With Dental Health

Although child health experts recommend that children begin oral health care by age 1 or when their first teeth emerge, a new report from the University of Michigan Health System C.S. Mott Children's Hospital National Poll on Children's Health shows that most children ages 1-2 have not yet started seeing a dentist.

In May 2011, the National Poll on Children's Health asked parents of children ages 1-5 about dental health care for young children. The poll found that only 23% of 1-year-olds had been to the dentist and only 44% of 2-year-olds had been to the dentist.

"Dental problems such as early childhood caries (cavities in the baby teeth) are the leading cause of chronic disease for young children," says Sarah Clark, M.P.H., Associate Director of the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan. "Most dental problems can be prevented through good oral health care."

Parents may not be aware of recommendations for early dental health care and finding a dentist who will see young children – especially those covered by Medicaid – is a long standing problem in some communities. To address these issues, pediatricians and health care providers are now seen as important partners in oral health and are encouraged to discuss oral health during well-child visits.

Straumann CEO Says U.S. Dental Market Hasn’t Recovered Yet

Straumann Holding AG, the world’s biggest dental implant maker by sales, views the U.S. dental market as stable at best, Chief Executive Officer Beat Spalinger said in an interview.

“The whole discussion about sovereign debt is clearly influencing consumer confidence,” Spalinger said by phone today. “Consumer confidence is key for our business in terms of market growth.”

The company has started a share repurchase program of up to 100 million Swiss francs ($1143 million), Spalinger said. There is no timeframe for completion, he said.

Straumann earlier today reported a 5 percent rise in third- quarter sales in local currencies to 150.7 million Swiss francs. The strength of the franc against the euro and dollar cost the company 60 million Swiss francs during the first nine months of the year, it said.

Straumann still expects an operating profit margin for 2011 in the high teens, excluding an impairment charge related to business affected by the earthquake and tsunami in Japan. Straumann expects the market will grow in the low-to-mid-single digit percentage range this year.

Enjoy your morning!