5 things I wish I could change about the Dental Industry

By Michelle Strange

It's funny; the more I learn, the more frustrated I become with the dental system as a whole. I've started studying to become a myofunctional therapist, particularly focusing on the links between oral health and systemic issues in the body. With this knowledge comes a growing unease. Why? Because I realize my patients need more attention than I have time to give.?

Move from provider-centered to patient-centered?

Let's start with the biggest block to change. Most of the industry is provider-centered, not patient-centered. Many practitioners don't see the whole person; they just see a cavity or a tooth that needs to be pulled. What about suggesting exercises to teach the patient how to prevent an issue from arising again??

It doesn't often happen, and if there is no thought, then there is no change. We need to shift focus to the person, not just the problem. Factors outside of our clinic can affect a person just as much as their biology. In fact, medical care, genetics, and individual biology account for less than a third of what determines health. Environment and social circumstances play a huge part, and we need to provide care that recognizes, respects, and includes these in their treatment plan.?

Understand that prevention is better than cure

Preventative dentistry is not practiced nearly as much as it should be. Only a tiny percentage of patients actively take steps to have regular oral exams, cleaning, and routine x-rays. The importance of oral health in relation to systemic health is well documented, and we know that preventative dentistry can reduce the incidence of dental disease.?

Still, there are barriers to promoting preventative care. A vicious cycle of patients not being aware of the importance of prevention, practitioners not having time to impress upon their clients its importance, and a system that sees dental health as a 'luxury' and not a necessity are all contributing factors to this.?

The best way to get out of the cycle would be to educate people at a young age about the importance of oral hygiene, particularly in vulnerable parts of the population. It is well documented that early childhood oral health sets the trajectory for adulthood oral health.

Bridge the disconnect between medical and dental

I'm often met with confusion and curious looks when I ask to contact a patient's medical provider. They don't understand why my care matters. But the question really should be: why is oral health left out of disease management plans when it can have such an impact on speech, nutrition, growth, and function??

This historical disconnect between medical and dental needs to change. When accounting for personal health care spending, oral disorders sit in the top 10 most expensive, mainly because dentistry is not considered nearly as medically crucial as other forms of healthcare.

It is time to re-write the joke that is dental insurance!

Dental insurance is a joke. I want to extend my appointment times, but I face financial loss if I do. That's if my patients can get dental insurance at all. If they are one of the lucky ones employed by a company that provides dental with their insurance policy, it increases their likelihood of having a checkup each year. This provision, over a lifetime, reduces their need for invasive dental treatments.?

Vulnerable groups, even with insurance, face extensive barriers to proper, preventative dental health care. Lack of coverage, insufficient coverage, inability to find a dentist that accepts their insurance, waiting for coverage to take effect, and poor quality of care for the underinsured all cause delays in seeking treatment or not bothering to get treatment at all. Then there is the state-to-state variation in what is covered, with only 20 states offering a comprehensive mix of services. Mind-boggling, right?

Improve focus on multiple modalities of dental care

There are so many different ways we can treat our patients. Myofunctional therapy, oral hygiene instruction, and nutritional counseling, to name a few. Myofunctional treatment can have a systemic influence; in some cases, it has even been proven to improve body posture. The provision of nutritional counseling would be another great thing to incorporate into our sessions with patients. Unfortunately, oral health care providers often cite a lack of time and remuneration as a reason for not doing so.?

Whether it be a discussion on sleep habits, mouth breathing, or dental nutrition, most patients I have could really benefit from the many modalities of dental care.?

The bottom line? I want to treat my patients the way I feel is best for them, holistically, but the system makes it extremely difficult to do so. These things I wish I could change today. But many may not change in my entire career. However, I continue to fight, to push back against the system, disrupt the status quo wherever I can.

Who is with me?