The American public needs to hear something vitally important about their health.
Especially since, as in many areas of public discourse today, powerful vested interests are making effective attempts to block and obscure the truth.
In this case, dental "insurance" companies.
First off, I need to say that there are three common diseases that we dentists mainly treat.
Cavities of course is one. Their end effects are far more serious than the word "cavities" makes it sound. Pain, loss of smile beauty, dangerous infections, loss of teeth, and with enough loss of teeth, loss of vertical dimension of the whole face ... Very serious stuff.
Periodontal disease, periodontitis, is the second. Periodontitis is a terribly serious systemic disease. Dangerous pathogens enter the bloodstream from the mouth with every meal, every toothbrushing, every heartbeat. Periodontitis dramatically increases the risk of heart attacks, strokes, various cancers, impotence, premature babies and a host of other ills. Periodontitis measurably shortens lives.
The third is oral cancer. When this occurs, early detection is vitally important.
Early treatment is a simple surgical incision.
Later treatment is surgery, radical neck dissection and chemotherapy.
Really later treatment is a prolonged agonizing death.
And here's the thing. Cavities, periodontitis, oral cancer--none of them ever get better on their own. None of them ever stay the same. They all get worse, at a variable rate.
With that as background--
Seen through the lens of oral health, we can conceive of several categories of people in America.
One category is those who, dental "insurance" or not, visit their dentist on a schedule. These people understand the value of early treatment and, even more important, prevention of disease.
Another category is, sadly, those who truly cannot afford dental care. This is a huge societal problem. See above about shortening lives.
I and many colleagues perform pro bono treatment from time to time. Even these efforts, regrettably, are not enough to solve this vast challenge that our culture faces.
Another category, and the one I mean to speak to here in this post, is:
People who think they can't afford to come to the dentist because they don't have dental insurance.
Well, please allow me to utterly destroy that errant belief:
Dental "insurance" is NOT medical insurance!
It works completely differently.
Dental "insurance" has become a cruel, sick joke.
In 1967, when dental "insurance " became a force in America, the most common yearly maximum was $1,000. And there were generally no payroll deductions for it--dental "insurance" was a perk.
Fast forward to today, and 95% of the dental "insurance" plans we see today are $1,000 a year maximum.
Folks, you have to use an inflation calculator to understand any of these financial issues. $1,000 in 1967 is $9,400 today.
If you have dental "insurance," you are getting 1/9th the value of what your 1967 predecessors were getting, and you are paying payroll deductions for the "privilege." They were not. You should be very, very angry about this.
Another way of putting this is, in the 1990s, patients in my practice could need, say, two root canal treatments and two crowns in the same calendar year and have the cost of all this complex treatment offset by 50%. Now? One root canal treatment and you're done with benefits for the year.
Done.
No funds left for that one crown; that's all on you.
When does it all become absurd? Very, very soon, at current rates of inflation.
The other unbelievable thing going on here is that dental "insurance" companies, which operate as 501c non-profit entities, haven't raised payment rates in my region since 2014 with few exceptions, and several of them categorically refuse to ever do so going forward. But of course, they raise the premiums they charge to the employers who purchase their plans, year after relentless year.
This profit-mongering policy cruelly and blatantly ignores increases in dental staff salaries, ignores inflation generally, and ignores the cost of highly beneficial new dental technology. In essence, dental "insurance" companies are paying for extinct dental treatments on the basis of fees appropriate for the 1990s, if not the 1980s.
And so. For those of you who do not have dental "insurance":
You do not need it.
It's a big yearly coupon at best.
When it comes to the objection of "I can't afford it":
First, you need to find out what "it" is. You need, and as a human being you deserve, your diagnosis.
And then you would be wise to recognize that if you don't have dental "insurance," all that you're lacking is a yearly coupon. A big coupon, yes, but not a game-changer coupon.
In closing, it's best to be clear-eyed about the purely financial advantages of early treatment.
Let's say that for a given diagnosis, the cost of treatment is $X.
Waiting for a few years lets the destruction from cavities or periodontitis grow, until the cost becomes, say, 11 x $X.
Wait a few years longer, and if in the end you decide to do ideal treatment, something beyond extractions and dentures, or extractions and just have no teeth at all, the cost might become something like 53 x $X.
Do you want to pay $X?
Or 11 x $X?
Or 53 x $X?
"I can't afford to go to the dentist" is always the least true right now at this present moment, because it becomes more and more true the more time that passes.
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