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Why Dentistry Is Separate from Medicine
- grabcocque 10y agoDespite the article's pretence this is some universal historical wart, I take it this is an American foible, another artefact of the arcane clusterfuck that is US healthcare? In the U.K., dental care is available on treated on the NHS just like other forms of care.
- halflings 10y agoWell... most people I know go to a private dentist, even if they go to their NHS-covered GP. Isn't coverage different for dentists?
- JetSpiegel 10y agoNot in Portugal. There's almost no dentists working on the public sector, as opposed to pretty much all other medical specialities.
- Aaargh20318 10y agoIn the Netherlands it's completely separate too, including in insurance.
- tirant 10y agoExcept for children. And I've seen that in other European countries as well. Children dental care is always included in public health care, and even the dentists share clinic with other doctors.
- pif 10y agoIn France and in Italy they are formally treated as a whole, but in practice they are two separate worlds. In particular, financial coverage in France and availability in public structures in Italy are very different between "dentists" and "doctors".
- gpvos 10y agoI don't see the article claiming universality outside the US. But in many European countries, dentistry is indeed largely or completely separate from the rest of medicine.
- dazc 10y agoIt is technically available but it isn't universally free and most people who have a choice elect for private treatment anyway. NHS dentistry in the UK has a very bad reputation, mostly deserved.
- rollthehard6 10y agoI'm not sure how true that is? Would like to see some statistics on how many people elect for private vs NHS. Myself I've never had private dental healthcare and have no complaints, especially since I am paying probably an average of around 150 USD a year for my dental care and can pay as little as 30 USD a year typically.
- toyg 10y agoI think the key is "most people who have a choice". That translates as "most people who can afford to spend a few grand per year on dentistry without really noticing". I guess parent is a bit more upper-middle class than you.
- rollthehard6 10y agoMust be as I'd certainly notice a few grand per year being spent on dentistry ; )
- arethuza 10y agoPrivate dental insurance in the UK is most definitely not "a few grand per year".
- dogma1138 10y agoPrivate dental insurance in the U.K. doesn't cover as much as you think.
- arethuza 10y agoWell, I get regular checkups and when I need work they do it - I haven't encountered any areas where stuff wasn't covered. Edit: Pretty sure I pay £30 odd a month and I've had root canal treatment, new crowns, etc.
- rollthehard6 10y agoThere is still a divide in the UK - unlike general medical care, dental care is not 100% free at the point of use (Similar for optical care). Dentists can take a mix of private and (public) NHS patients or specialise purely in private or NHS. If you move to a new area it can sometimes be hard to get into a practice as an NHS patient. NHS dental care is heavily subsidised but not entirely free (See here for prices where I am in Scotland - https://www.scottishdental.org/public/treatment-charges/ https://www.scottishdental.org/public/treatment-charges/) Typically, if I get a check up and need nothing done other than scale and polish the cost is around 15 USD (The exam part being free) As a consequence, having some dental insurance plan is not uncommon here - my partner needs more dental work than I do so has such a plan called Denplan.
- _nalply 10y agoIn Switzerland mandatory health care doesn't cover dentistry except for tooth accidents and serious illnesses. As one can imagine some grey areas can make it difficult to determine whether a dentist treatment is covered or not.
- peteretep 10y agoThis is deeply misleading. All non-emergency health in the UK is mediated via your GP. Except dentistry. All expert medical procedures in the UK will be carried out by an MD, no matter what part of your body they're on. Except for your teeth. For any serious medical treatment in the UK that requires anaesthesia, or surgery, you are likely to be treated at a general hospital which happens to have an appropriate unit. Except ... dentistry, where they have specialist dental hospitals. Finally, treatment on the NHS for all medical conditions is free at point of use, except for prescriptions. Except dentistry, which is merely subsidised, and generally provided by dentists who work privately, and offer to provide slightly different treatments on the NHS than they do privately.
- dghf 10y ago> All expert medical procedures in the UK will be carried out by an MD, no matter what part of your body they're on Point of pedantry, which doesn't really affect your argument: the professional medical degree in the UK is the MBChB (Bachelor of Medicine / Bachelor of Surgery -- abbreviation can vary by institution). The MD is either a research degree (similar to a PhD) or, at certain older universities, a higher doctorate similar to a DSc. In either case, most British doctors don't have one.
- kalleboo 10y agoIn Sweden, dental is treated separately. There are public dentists, but they're only free of charge up to age 19, and after that there are only a couple rebates available (IIRC the government will pay 30% of procedures over a certain cost, and every other year you get a check that covers one checkup) In Japan, basic dentistry is covered the same under national health insurance, but for instance if you want a ceramic crown instead of metal, you have to pay for that yourself. Dentists and general medicine are completely separate institutions though.
- deleted 10y ago[deleted]
- vacri 10y agoLet me add an Australian voice to the "Yup, there's a dental divide" cacophony.
- pjc50 10y agoEven further on the fringe of medicine: opticians.
- peteretep 10y agoThat's a bit different, as an opthalmogist is a real doctor who treats eyes. Dental equivalent would by a dental hygienist, I guess.
- barking 10y agoOphthalmologists are specialists just like any other medical specialist, e.g. a dermatologist. Does the fact that general practitioners refer people on to dermatologists mean that family doctors are not 'real doctors'? Sorry if that sounds aggressive, I am unfairly taking the inference from what you said that opticians are somehow 'fake'.
- dogma1138 10y agoOpticians and ophthalmologists are different things. And optician had some training but it's not a medical degree which is equivalent to say a dental hygienist in dentistry.
- masklinn 10y ago> I am unfairly taking the inference from what you said that opticians are somehow 'fake'. Opticians are equivalent to pharma techs (or dental hygienists as dogma1138 noted), could you be thinking about optometrists (sometimes called Ophthalmic Opticians in the UK)?
- barking 10y agoProbably, I wouldnt know which is which. I have been very impressed any time I've had my eyes checked.
- deleted 10y ago[deleted]
- barking 10y agoDentists in the UK receive a bachelor degree, as do doctors. However it was a sanctionable offence in the eyes of the General Dental Council for a dentist to title themselves Dr. This was purely a Dental Council regulation, anyone at the time could call themselves doctor, it wasn't a criminal offence. With the arrival of dentists from EU countries who were allowed to do so, UK dentists felt they were being put at a disadvantage in the eyes of the general public. The GDC eventually relented with an announcement to the effect that dentists doing this would not be taken action against any longer. But they clearly didn't approve!
- partycoder 10y agoIn the US they have the title of DDS (doctor of dental surgery).
- chimeracoder 10y agoThough in the US, they receive a postgraduate degree (as do medical doctors), not just a bachelor's. Technically they could receive that degree without a bachelor's degree, but I've never heard of anyone getting into medical or dental school without having received an undergraduate degree.
- barking 10y agoTypically, here, people start studying medicine or dentistry straight out of secondary school at 17 or 18 years of age. Medics qualify 5 or 6 years later with an MB (Medical bachelor), dentistry (Bachelor of Dental Surgery) typically takes one year less though the summer breaks for dental students can be as short as just one month. They can be back doing practical clinical dentistry in early August while the medical students are off until the start of October.
- ww520 10y agoThe title "doctor" has been abused by different trades. Optometrist is Doctors of Optometry (O.D.s). Pharmacist is Doctor of Pharmacy (Pharm.D). Nurse has the Doctor of Nursing Practice (DNP). Veterinarian is Doctor of Veterinary Medicine (DVM). Physical therapist is Doctor of Physical Therapy (DPT). Chiropractor is Doctor of Chiropractic (DC). Of course dentist is Doctor of Dental Surgery (DDS). Medical doctors have to use another term Physician to avoid the confusion.
- feld 10y agoDental/oral health is crucial. You can die from dental problems. I will never understand why the entire dental industry is treated as if it is cosmetic or non-essential. Stress to your immune system and failure of major organs is not taken seriously, but it is a very real risk.
- wslh 10y agoYou can also detect certain kind of cancers via oral inspection.
- err4nt 10y agoAnd I've heard organ diseases and organ health can sometimes be immediately evident to experienced dental workers that doctors inspecting other areas of the body might not see as well!
- dsego 10y agoRecently there was a case of a woman having to undergo brain surgery after bacteria from an untreated tooth attacked her brain. She's now learning to walk again. badly translated article https://translate.google.hr/translate?sl=hr&tl=en&js=y&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.jutarnji.hr%2Fvijesti%2Fhrvatska%2Fuglednoj-novinarki-jedva-spasili-zivot-zbog-upaljenog-zuba-umalo-sam-umrla-bakterija-mi-je-napala-mozak-sada-ponovno-ucim-hodati%2F5659955%2F&edit-text=&act=url https://translate.google.hr/translate?sl=hr&tl=en&js=y&prev=...
- Rainymood 10y agoMake sure to poke a very thin wooden stick regularly (daily, before bed, after brushing) between your teeth and marvel (or be disgusted) at the amount of plaque that comes out which you missed by just brushing -- honestly it's an insane amount.
- vinay427 10y agoIsn't this more commonly known as flossing?
- 7sigma 10y agobetter than wooden sticks and flossing are the interdental brushes. Those clean a lot better in my experience and my oral health improved a lot after i started using them.
- mturmon 10y agoThese brushes helped me a lot too. The brush is a lot easier for my large hands to manipulate than floss is, so regular use of the brushes has given me better results. Alas, I had to learn the hard way not to neglect my gum health.
- ar-jan 10y ago> after brushing Before brushing, I'd say. Then the fluoride in the toothpaste can better reach between the teeth.
- cesnja 10y agoPersonal anecdote, but that way, you might also push some harder pieces of food under the gums (most of those leftovers won't be there if you brush first). It happened to me after eating some hazelnuts and flossing before brushing. The gums swelled up for a few days.
- mtdewcmu 10y agoThe real question is not why is dentistry kept separate from medicine. The real question is why dental insurance is treated like a luxury, compared to regular health insurance. The problem is that so many people are unable to afford dentistry, because of poor or no coverage.
- brianwawok 10y agoI think it is cost scale. Get cancer? That could be a million dollars in treatment. You need insurance. Get a bad tooth? Maybe 3k max to replace it with a bridge or similar. The idea is most people can scrouge up 3k but not a million bucks.
- nerdponx 10y agoThis is ass backwards to me Preventative dental work is dirt cheap and corrective dental work is relatively rare, and costs rarely spiral out of control. That sounds like a much better deal to me, as an insurer, than insuring any other body part.
- maxerickson 10y agoPreventative care isn't really insurable though.
- chimeracoder 10y ago> Preventative dental work is dirt cheap and corrective dental work is relatively rare, and costs rarely spiral out of control. That sounds like a much better deal to me, as an insurer, than insuring any other body part. When costs are easily predictable, that's actually a terrible case for an insurance model. Insurance is about smoothing risk, not making things cheaper. In fact, for services that are relatively cheap and predictable, insuring against those events will always be more expensive than paying for them out of pocket, because of the additional overhead. Financially, the expected value of insurance is negative (the sum of all expected payouts is less than the sum of all future premiums). The reason it's valuable is because it reduces the variance in the month-to-month payments, which is a useful product for some people.
- 10dpd 10y agoNHS Dentistry in England and Wales is one of the biggest hidden scams yet to be revealed. The 'Unit of Dental Activity' scheme encourages dentists to delay treatment unnecessarily to cover their basic costs. The sooner the UK government acknowledges that the current NHS Dentistry setup is not sustainable, the better it will be for all.
- partycoder 10y agoIn the middle ages, the main practitioners of medicine were "barber surgeons", barbers that were also surgeons and dentists. https://en.wikipedia.org/wiki/Barber_surgeon https://en.wikipedia.org/wiki/Barber_surgeon Also, all this was done in a very unsanitary way. In fact medicine was unsanitary in the West until Florence Nightingale conducted an statistical survey showing that cleaner spaces had fewer mortality rates.
- kome 10y agoIn Italy, until the 1980 dentists were medical doctors that decided to specialize in dentistry. It's still the case for a large part of them. But now there are separate schools.
- autokad 10y agoi'm very happy its under a separate umbrella. think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level. currently it costs 150$ to show up 10 minutes early for an appointment to be seen 20 minutes late for an interaction that lasts 5 minutes. and then i say 'my knee also hurts' and they say you need to schedule another appointment if you want to discuss any other ailments. insurance covers 100$ of that, but I am under no illusion of the cost. do we need to raise dental awareness? sure. do we need to put it under the bureaucracy and price fixing of the medical system? i dont think so
- mivade 10y ago> think of all the years of unnecessary education they'd pile on to dentistry and the bottle necks they would put up to raise the wages to MD level. That seems more an indictment of the medical education system than the insurance system. There are already parallel medical education systems in the US (MD vs. DO, although there is little practical difference). Seeing either type of physician is treated equally by health insurance. Why can't health insurance also cover DDS visits as well?
- chimeracoder 10y ago> MD vs. DO, although there is little practical difference). Seeing either type of physician is treated equally by health insurance Uh, not exactly. MDs and DOs do receive different sorts of education, and insurance can distinguish between them.
- Broken_Hippo 10y agoThis isn't necessarily true. Most dentists won't even need additional education - after all, we are actually just trying to get what they do covered. It doesn't mean the system or education must change, and in practice it will be like going to a specialist without having to visit the GP first. You wouldn't complain to the gastric specialist that your knee hurts either. The bigger changes would be in health insurance coverage and things like that. Basic cleanings are more likely to be cheap: extractions might wind up costing more if one must pay their deductible first. Sure, some of the services will continue to be cosmetic only - but plastic surgeons (who often also do reconstructive surgery along with complicated dental extractions) seem to manage this just fine. You being seen on time isn't an issue with this, honestly. Some doctor's offices have a habit of being on time. You can let them know upfront that you have multiple issues as well - this allows them to schedule more time with you (and bill insurance accordingly).
- bigtex 10y agoBreak a tooth on a Friday night and need dental work? You think, I will goto the ER and they can help. Nope, they will just give you medicine to deal with the pain until you can see your dentist on Monday morning. I am not aware of a ER in the DFW area that has a dentist on call.
- jonwachob91 10y agoThe most painful thing about this article (and the comments) is the lack of understanding that Doctor is a level of education not a field of study.
- merqurio 10y agoI just saw this week an endocarditis due to the lack of dental hygiene. None of us was properly trained to evaluate if the patients teeth were ok. Shame. Dental health is not even available in lot of public health system like the Spainish one. I'll never understand why it's treated differently.
- drcnyu555 10y agoLet's settle the dust! Dentist here; what's up ?
- qrbLPHiKpiux 10y agoDentist here, too.
- drcnyu555 10y agoGreat . its unusual to find dentist on HN . Where you from my friend ?
- dmersky 10y agoDo the math and you'll find dental insurance is a ripoff. Additionally, while some people can't afford much of anything, others who complain about the cost of dental care, buy things as or more expensive because they value those things more: Big screen TV for example. They don't value dental care as much, until they are in pain. Then they expect an entitlement. People pay for what they want. Dental insurance is a subsidy, not insurance. Delta Dental of CA has over $600,000,000 invested in tradable securities. They didn't pack away that much money giving away dentistry for free.
- qrbLPHiKpiux 10y agoDelta Dental of CA has over $600,000,000 invested in tradable securities - all from your premiums paid to them with a piddly $1000 annual maximum with absurd limitations. I agree. It is a scam.