Is Hilary the Healthcare Presidential Candidate?

Hilary has been quoted as saying she "wants to be the health care president" Her opponent John Edwards has implied she may become one by negotiating compromises with the insurance and pharmaceutical industries. This would be a shame since in my opinion allowing these two industries a large voice in our health care reforms is similar to putting the fox in charge of the hen house. Let us hope that our national health care debate can tackle real issues and come up with some meaningful changes that provide a more equitable health care system, one that provides quality healthcare to all. Universal Coverage is a tantalizing idea, but we must be aware that we, the public, will have to pay for it.

How Long does Bonding Last?

Bonding, used as either a laminate over a tooth or as a filling material can last a long time. With proper care and a little luck bonded restorations can last between ten to twenty years. The patients home care is important since bonded restorations are quite sensitive to break down when plaque is allowed to remain undisturbed on their surface. The plaque tends to create porosities in the bonding and bonded filling which are chronically "buried" under plaque appear "water logged". The bonded fillings appear to have absorbed moisture from the mouth and don't seem to fit as well as bonded fillings that have been kept clean. Also in unclean mouths bonding is more likely to become stainned and unattractive. Also, a patients bite,a hard diet consistency and oral habits(bruxism and tooth grinding) can shorten the life expectancy of a bonding , since bonded fillings sometimes crack and separate from teeth.

Is Bleaching Teeth Harmful?

The short answer is no. I have been bleaching teeth since the middle eighties and have whitened probably over five hundred mouths. I have not seen any permanent harm come to any of my patients teeth. There is often a transient sensitivity which goes away within 48 hours of the last bleaching session and sometimes shortly after the teeth are bleached sometimes one can notice some white chalky spots for a period of time. White spots tend to fade after sooner or later. I have read that the entire bleaching process has a decalcifies the teeth about the same amount as two cans of coke would. None of my patients have developed cavities as a result of bleaching and about 98% are pleased with the results and would do it again if they had the opportunity.

How Long Does Teeth Bleaching Last?

After people whiten their teeth, usually their teeth usually remain brighter than their original shade for years. Most of my patients do touch up their bleaching, once or twice a year, by wearing their bleaching trays for two to three nights. If a patient had their teeth whitened using an in office light assisted method, touch ups can be more problematic, if they haven't had bleaching trays also made. Over the counter whitening products, such as White Strips can be used and can work well.

Boom Time for Dentists but not for Teeth?

Recently an article written by the New York Times reporter Alex Berenson has been a topic of conversation around my office and with my friends.

The article, tittled"Boom Time for Dentists but Not for Teeth ", implies, in a rather mean spirited way, that dentists are greedy and somehow the cause of our country's apparently worsening dental health. It sites the lack of proper care for the indigent and the fact that "up to 100 million Americans-including many adults who work...are without access to care." Furthermore, he indicates that dental fees have risen faster than the rate of inflation and that fewer Dental Schools exist now than in the 1980's. His implication clearly is that dentists and their ilk are to blame. He has one expert quoted as saying "Dentists consider themselves to be in the business of dentistry rather than the practice of dentistry."

Yes, Dentistry is a business, and even well run dental offices have overheads between 6o-70%. Dental Schools have closed because the Federal Government drastically cut aid to dental education and some dental schools folded. If government wanted to provide a greater subsidy to dental school training I am sure this trend could be reversed.

Yes, it is a fact that many people choose not to go to the dentist regularly, partly because of the expense, but that is not entirely dentist's fault. Dentistry is costly and unlike medical care , dental insurance doesn't cover more expensive treatments and many people don't have dental insurance. That doesn't necessarily mean that dentists need to lower their fees .

The problems with dental care at least in part are similar to the problems with medical care. As time goes by new techniques and technology are made available to both professions, but at a cost. When I speak to people about their dental experience they often comment on the newest technological gadget that their dentist has incorporated into his practice. The public has come to expect it and dentists know that it makes good business sense to invest in technology, sadly sometimes even when it is not necessary for improved dentistry.(yes dentists do things sometimes to help them make money!-show me a profession that is not interested in making more money!)

I do think the basic problem with the article is that it essentially is scapegoating the dental profession and the ADA, when really the enemy is our own society and societal values. We do not have a European system of high taxation and a government that heavily subsidizes all health care regardless of a person's financial need.

Dentistry is a mostly private system and is an area that for the most part is not a major governmental priority and care of teeth are treated as an after thought. Although medicaid pays for dental care, it pays poorly and in New York it tends to pay most hospital programs a higher rate than private dental offices. Consequently there aren't many dental offices that participate with the medicaid program.

If society wants to train expanded duty dental auxiliaries to provide a broader scope of supervised treatment I have no problem with that, but it doesn't get to the heart of the matter-We as a society will have to pony up to reality that dental care has to be paid for by someone and is not primarily a charity process.

Taxpayers will somehow probably be footing the bill and it is not a popular subject, just as the rationing of health care is the third rail in the ongoing political debate on health care system.