A new world for dentistry

By Dr. Stephanie McGann, DMD FAGD, Columnist, The Times

It’s a new world in dental care and most people just don’t know.

Online dental consultations, called teledentistry is here and here to stay. Have a question? Need advice? Don’t know what to do? For a small fee you can go online to a number of different teledental sites, answer a few questions and get hooked up with a dentist licensed in your state. Needless to say this does not replace a visit to an actual dental office but it can be a great way to get started.

Corporate dental practices are taking the industry by storm. What’s the difference? First, once upon a time, you went to your dentist, a professional and small businessman (or woman) who owned the practice and cared for their patients. They may have grown and brought in an associate dentist or two but at the end of the day the owner was always there to be sure things were done right. Patient care and reputation of the practice was first and foremost. Dentists were able to charge a fair fee and made a reasonable living.

Then came the “networks” dentists agreed to a much lower fee in exchange for the networks filling the extra time in their chairs. None of us foresaw the day when everyone would be in a network. These small businesses had to find a way to do more with less reimbursement. They found themselves having to hire more staff just to process claims and authorizations. More regulations meant more time out of the office for training, more overhead. The number of patients who “no-show” their appointments increased as the value of the services were diminished by network administrators. Dental practices as a small business are dying off as the costs of running a practice and providing care were starting to exceed the reimbursements.

To stay in business many dentists look to DSO’s (Dental Service Organizations) these corporate entities handle all of the non dental services for the practice, billing, payroll, accounts receivable, supply vendors and more. Because they handle the needs of many practices they can get a better deal on many services than a lowly small business. DSO’s then increase their management role by demanding dentists make “quota” or are compensated on a commission basis. To do this they are expected to bill a certain amount per hour. Imagine the stress of a young dentist, graduating with an obscene amount of student debt and having to please their bosses. Some of these practices have names you recognize and some quietly keep the name of the practice they acquired. Just like the family physician with an office on the corner is now forced to be part of a “health system” the same is happening in dentistry.

Even more startling is the new do-it-yourself model of healthcare. Soon you will be able to walk into a CVS, get your teeth scanned and for a fraction of the cost of traditional aligner orthodontics, a company will mail you trays designed to straighten your teeth. Sounds like a great deal. Every dentist and orthodontist who has done aligner orthodontics knows, it’s just not that easy to get a great result. The other big concern is will it do harm? Moving teeth in some cases may actually cause damage to the teeth or supporting bone. These kiosks don’t have anyone looking at xrays or evaluating your dental history. Words to the wise, buyer beware. It will work for some patients some of the time, but it will not work for all patients all of the time.

You want a real laugh? Go on Amazon and search for dental laminates or dentures. The “fake dental stuff” is impressive. Just please, don’t buy it.

There are many changes in dental care and many more to come.

Dr. Stephanie McGann, who has more than two decades of dental practice experience, is a resident of the Unionville area and owns and practices at Rainbow Valley Dental, in Valley. She is a past President of the Chester/Delaware Dental Society and she is a Fellow of the Academy of General Dentistry.