Home Practice ManagementLeadership What is Wrong With Dentistry? It’s Unaffordable!

What is Wrong With Dentistry? It’s Unaffordable!

by Steven Mautner

Welcome to my first — and maybe last — editorial.

The topic of this diatribe: the inexplicable inability of dentists — despite having at their disposal amazing technology, procedures and skills — to read their markets and stop the decade-long decline in dental incomes (despite a recent uptick). Source: ADA Health Policy Institute.

First, some numbers. According to Sentier Research, the median household income rose (after years of stagnation) to $62,175 in June of 2018. In simpler terms, this is equivalent to $5,181.25 a month or $1,195.67 a week.

The average fee, according to CostHelper.com, for a dental exam and x-rays is $198 and a cleaning is $127. So, for a typical recall visit, the total is $325 for one person and $1,300 for a family of four. An average extraction (simple), according to Member Benefits, costs anywhere from $75 to $300. A porcelain-fused-to-metal crown, according to Colgate Oral Care, can cost between $875 to $1,400 per crown. Dentures, according to Bankrate.com, can go from $500 to $,1500 per arch. Authority Dental states a dental implant can cost between $1,000 to $3,000 and root canals can range from $300 to $1,500 (Nicholas Pell) depending on whether it’s an anterior, premolar or molar.

By now you should realize where I’m going with this. Just one dental visit can eat up an entire family’s monthly income. The reaction to these sky high fees has been low reimbursement dental plans, the creation of a new breed of provider (dental therapists), government intrusion (medicaid, medicare advantage, loan guarantees and expansion of dental schools), and the entry of private equity and DSO’s into dental practice.

The response by dentists has been to blame the ADA, the ignorant public, dental schools and greedy investors for their plight rather than looking inward at themselves and their practices.

For example, is it really necessary to charge $1,400 and spend 90 minutes on a crown when most of it can be delegated to a much lower paid dental assistant? Do we really need to schedule an hour for an exam? A prophy? Why not use the natural pauses in every procedure (waiting times for anesthetic, impression drying, assistant time) to go see another patient instead of sitting on your doctor’s stool and staring at your patient? Do you really have to “block schedule”? What’s wrong with “hustling” and even working through lunch? Taking walk-ins? The answer: nothing.

Unless you’re an extremely skilled dentist with a great personality with a practice in an affluent area, not doing these things is a recipe for struggle. Otherwise, the answer is to learn how to live on a median general practitioner income of $180,000 (which isn’t bad, but certainly not commensurate with the effort and money it costs to become a dentist). Good luck. Time to go, I have another patient.

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