The NYT article doesn’t make it clear – why is the private dentistry so expensive there? Does the fact that there is a “free” substitute destroy the market for low-end services such that only luxury goods at a luxury price can compete? Does the British government overrestrict entry to the profession? Is the profession overregulated? Of course it makes perfect sense that any “free” service would have severe shortages, but there has to be something more to it than that.

We have similar problems here in America. While low-income people are given Medicaid or other government sponsored dental insurance, few dentists aceept its low payments. In fact, about 80% do not. Dentists also won’t live or travel to rural areas – understandable since they are rich and want to stay rich so they go where the money is.

So now we have a dental health crisis in America. More and more poor and working poor Americans wait until the pain is so bad that it warrants an Emergency Room visit. Taxpayers’ usually foot this bill.

Things are getting worse as companies scale back and/or eliminate dental benefits and as government tightened budgets eliminate dental care for those that need it the most.

However, according to a Wall Street Journal article, dentists now make three times as much as physicians while working fewer days and fewer hours. In my opinion, they are pricing themselves out of business by concentrating on becoming cosmeticians using massage therapy, hand waxing and other amenities for their paying or insurance covered patients who are more likley to want highly priced cosmetic work.

Too bad that 80% of decay occurs in 25% of the population – mostly low-income and rural folks.

Enter Dental Health Aide Therapists, two year trained advanced hygienists (DHATs), who drill, fill and bill (but more cheaply than dentists) in areas and mouths where dentists refuse to enter. DHATs have worked successfully for decades
in Canada, New Zealand and other countries.

Enter the American Dental Association who is suing
the Alaska authoritieis who are allowing DHATs to treat rural Alaskans where ADA dentists won’t go.

The ADA says they worry so much about the “inferior” work of the DHATs.

Obviously the ADA is just protecting their lucractive monopoly while giving the illusion they care about the poor by instigating and promoting water fluoridation which has been a dismal failure and preventing tooth decay.

Dentists patted themselves on the back for endorsing fluoridation because it would put them out of business – well they certainly fooled a lot of legislators who handed them lots of laws that
helped them get so rich. This year alone the American Dental Association spent almost a million dollars lobbying for reforms that would help them remain rich.

Nyscof has the right idea, but fails to take it to the logical conclusion.

The reason for fewer dentists is the same as the lack of “free” dental service: Government interference.

It’s right there: the government is “allowing” the non-dentists to work.

Licensure creates shortages. Shortages mean higher prices. The ADA and AMA create artificial shortages of dentists and doctors for the specific purpose of creating monopoly prices.

So rescind the legal protections against competition that are granted to the ADA, AMA, IBEW, MLB and other true monopolies. Let competition rein and watch as prices drop while availability no longer is an issue.

That said, I will gladly pay more to go to the dentist I found in San Jose, California: Douglas Larson. He is not only an artist in cosmetic stuff, which I have not done, his work in “regular” dentistry is wonderful. Even if there were no regulatory burden, he would still be well paid for his services because of their quality.

The only people de-regulation endangers are the hacks, quacks and idiots who can make a living only because they bought a piece of paper that says they can.

I suspect these stories are bogus and placed to help lobby for increased NHS spending.

When I go back to the UK these days it seems like everyone has even, white teeth, nothing like the bad old days of the NHS monopoly.

Over here in the UK, the NHS (National Health Service) is supposed to provide dental cover for everyone; it was never supposed to be otherwise. However, alas, the dentists refuse to go along with this government moral blackmail because the NHS will only pay dentists pitiful non-market amounts to carry out the work. So therefore there is very little NHS cover. Some dentists feel guilty about this lack of provision and do sometimes admit NHS patients, but often only if they are children. Occasionally, a rather brave new dentist, straight out of dental school, will go to a town without NHS dental cover and announce that they are starting a new NHS dental practice. The queues form almost immediately, and I’m talking about real Soviet-style queues down the street, with sometimes hundreds standing waiting to register their names. After a few years working like a Stakhanovkite coal face worker, drilling and filling like crazy for the meagre NHS payments, and dealing with ungrateful chippy patients, most dentists give up on NHS work (perhaps keeping the children part going), and retire into the better-paid and more relaxed sanctity of private dental practice. The US scare stories are perhaps a little over-blown to sell newspapers. Most private dentists charge fairly reasonable prices (let’s say $50 dollars for an annual check-up and perhaps $100 dollars for a drill and fill), and most people can afford these kinds of prices. It does, however, get really expensive, if you need difficult treatments (e.g. tricky calcification root canal jobs needing several sessions involving an experienced dental surgeon). But most private dentists here stick to simple work, and refer their patients on to the more expensive specialised surgeons in such cases. People here do have, I think, better teeth than a couple of generations ago, because most people use private dentists. By the way, many people avoid NHS dentists even if there is one of the rare ones available, because of the conveyor-belt nature of the treatment, the overcrowded waiting rooms, the rushing dentist trying to get through five or six patients an hour, and the occasional horror stories. For instance, because of the way the NHS payments are structured, it often makes sense financially for an NHS dentist to follow one course of action (e.g. a tooth removal), rather than a more time-consuming treatment (e.g. a root canal) which the NHS will only pay a pitiful amount for. So the tooth gets removed, where a root canal would have saved the tooth. I’m making these figures up, immediately below, but this is the kind of thing I mean: (i) Private cost of drill and fill: $100. (ii) NHS payment for drill and fill: $80. (iii) Private cost of root canal: $200 (twice as long to do). (iv) NHS payment for root canal: $100 (twice as long to do). The NHS say they do this to prevent dentists ‘ripping them off’ with unnecessarily expensive treatments, which may be a point to debate. (What they forget, of course, is the way the British government has ripped off the taxpayers in the first place!) With hundreds of patients therefore each day knocking down the doors of NHS dental practices, putting the morally-pure ‘socialist man’ dentists under severe time pressure, and with the payments skewed towards basic treatment, the general air of an NHS dental practice is usually one of a second world war air-raid shelter, being bombed. Having to live in the great NHS socialist wonderland of Great Britain, I’ll try to answer one or two questions from earlier: (1) Does the fact that there is a “free” substitute destroy the market for low-end services such that only luxury goods at a luxury price can compete?. There is that, but it’s a bit more complicated. The sort of people who in a free market would be at the lower quality end of dental treatment, are very chippy about paying ANYTHING towards the cost of their dental treatment. We have a general culture in Britain of expecting the state to provide every SINGLE aspect of health care. If any lower-cost private dentists were to set-up, they would be beset by patients moaning and groaning, and probably sometimes being quite aggressive (dental rage?), about having to pay the few pounds each treatment would cost. It’s much easier, if you’re a dentist, to go slightly further upmarket in order to avoid this unpleasantness. (2) Does the British government overrestrict entry to the profession? I know the government directly runs all medical schools, via the NHS, and therefore decides the numbers of entrants into the medical profession, probably along with the strictly impartial guiding hand of the British Medical Association, the trade union of British doctors. I’m pretty sure the same trick is carried out with regard to the dental schools (which are usually allied with the medical schools within the state-controlled University system). By the way, there’s a big stink here in the UK about the rate at which doctors are paid. All of the billions of pounds the Labour government was supposed to be improving the NHS with, appear to have disappeared into the hands of the doctors, after a series of incompetent government-led contract negotiations (the joys of spending other people’s money). Most General Practitioner doctors are now earning well over £100 thousand pounds. Okay, not much in US terms, but an awful lot more than they used to earn. There are even stories of some NHS general practitioners earning over £250 thousand pounds (approx. $400,000 dollars) from the NHS. Again, small beer to what your AMA-scam doctors are getting, but a lot more than NHS doctors used to get, and a lot more than most of their tax-paying patients. (3) Is the profession overregulated? Anything involving health care, personal client-consultant relationships, and education, is hugely regulated in the UK. As dentists fall into all three categories, I’d be surprised if the usual Gosplan-style directives don’t weigh down their every move. (4) Of course it makes perfect sense that any “free” service would have severe shortages, but there has to be something more to it than that. Hopefully I’ve given you a flavour of the dental situation here in Britain to answer that. It’s complicated, to be sure. But it’s just the same old usual statist central planning mess it is everywhere else, whenever these central planning socialist cretins take over any part of the free market. Unfortunately, the NHS is very much a sacred cow over here. It will be the last thing to be privatized. But even now, with the government having spent hundreds of billions of taxpayer cash in trying to make the damn thing work, and having been seen to fail in areas such as dental treatment and sacking thousands of NHS hospital workers, I maintain an optimistic air of hope that one day the NHS monolith will collapse of its own accord.

We need to realize we are responsible for our own health – most of the time. So choke down those 7 – 9 fruits and vegetables daily; stay away from junk foods and brush and floss. Only then will the list of available dentists be longer than the lines waiting for treatment. And prices will come down.

We are conditioned not to actually believe that what we eat affects our health, although we can all recite it very well.

The prices of UK dental work continue to astound me. Take a look at Private Dentist Prices. There you can see you could be paying thousands of pounds for pretty simple treatment. Although I did find something else on the web showing that prices have dropped around 20% over the last 3 years. Still expensive, but at least slightly less so!

Your entry reminds me of when I was a child growing up in Louisville. My pappy used to say “When life give you lemons, make lemonade”. But he was a hopeless alcoholic who never made much sense so I never paid much attention to him. Have a great day!

I can’t believe that they really use a laughing gas just to make he pain away. I think it’s more painful than a procedure without anesthesia because blood will spurt out in your mouth once you laugh. Ouch.