The article really has nailed the "dentist industry" on the head. She draws out comparisons with physicians, because this is the model with which we're most familiar. The most accurate observation to date is that dentists are more in charge of their fees and income than physicians and try to minimize cost overruns. The author doesn't go far enough though. In taking it to the next level I would say that dentists' first priority is their income, not your teeth or your health. And I've seen this THROUGHOUT my long history with dentists.

I had two great tools to bring me to good dental hygiene: one was my dad's dental plan and the other was a mom with no teeth. I ran into the income versus teeth paradigm in my rebellious teenage years. My dentist said, "You should get your wisdom teeth out. You have great insurance after all." And I thought, "Huh? Shouldn't it be, 'You should get your wisdom teeth out so that they don't present problems as impacted teeth in the future?" Well, I said, "no thanks." And in retrospect, I should have gotten them out then, but even a "do it now while it's easier on your mouth at this stage of your development...." would have done it for me. The overt GREED caused a knee-jerk reaction. And still does.

Today, I go the the dentist only rarely. The obvious bottom dollar for all my dentists (five or six to date) is just a major turnoff. Last time I went, I had to get a crown (the only dental problem I've ever had, but for the dentist- cha ching!). Any time I asked for an explanation of cost at stages of the procedure, she wrote me off. Any example of thte exchange:

"So, just what type of adhesive is that you're using?"

"The strong kind."

"How strong is it?"

"Well, this little dab I'm using costs $200. It's that strong."

"Uh, thanks."

I'm not a stupid man. I have a couple of graduate degrees and I know the health of my mouth is important. But dentists would get me in their office more than the once-every-four-years visit if they just weren't so damn money-grubbing (and treated me like I had a brain). The dental association sure has been good at nailing down the cost-benefit of dentists for consumers. Now they need to work on forming an industry that looks a little more altruistic. Or at least TRIES to.

Speaking of your crown, I had a dentist friend of mine explain to me the differences between different types of crowns, how they are made, etc. Basically, you get what you pay for. You wanna go cheap, you get cheap. Don't expect a well-made crown to cost $50 in parts and labor.

Which beg the question of the Slate author who thinks the low income non-payers will get top of the line dental appliances....have you ever gone to the barrio? There you will fine great examples of low cost dental work, especially in the children whose parents bought Bratz dolls instead of a toothbrush for the kids. Very fine silver-colored caps on baby teeth, if I say so myself.

DvB

Two things: if you've got a dentist and just kvetching about how much it costs to be healthy...go at it, but dont pretend that it's cuz you havent done your research. It's 2009 folks, if you're on this blog, you have access to information. I would never think to go to my physician without a list of questions to ask about my visit. Patients (and their parents and their significant others) have a list of questions they've already researched BEFORE they go to the dental (or medical) office. If you already have a dentist you are FAR ahead of the game!!!

It's the next part of the series (I hope) that will highlight the worst case scenario. No insurance and/or no dentist in the rural areas. Combined w/the rising cost of school loan indebtedness (thus making it difficult to even recruit new grads to those rural areas) and the rising cost of the actual practice of dentistry (as in the article, dentists are small businesses that pay for their own rent, equipment, insurance, supplies and salaries).

Most dentists are like everyone else, they have families and school loans, why would anyone think that they do not deserve to take care of their obligations?