By FDA President David F. Boden, DDS, MS
Really, the question should be: Why is my dentistry expensive? To answer that, I will tell you a story about what happens in your mouth, and mine.
With few exceptions, we are born with the code for great oral health. Our teeth grow and form and eventually say, “Hello,” to the world, hugged nice and tight by healthy gums, ready to do their job for our bodies in helping condition food for digestion. Soon after, they make their premiere, they will be exposed to the enemy of any mammal: bacteria. Bacteria have one purpose: to feed on us and break us down. But they also get a free meal every time we eat. They form colonies of bacteria on our teeth we call plaque, just like they do on high school biology class petri dishes.
Some bacteria convert parts of that food into acids, which allow them to etch into a tooth’s nice, hard, pretty enamel. If they are there long enough, those acids will eat right through into the nerve in the center of that tooth. Our body senses that and registers it in the brain as pain, saying something is very wrong and needs attention. There are other bacteria that make their homes in gums. They feed on tissues, triggering our bodies to fight back with what doctors call an inflammatory reaction. This causes bleeding gums, but unfortunately, the signals sent to our brains are very weak and do not register until a lot of damage has already occurred.
Both cavities and gum disease can cause tooth loss. Unless, of course, you see a dentist. That dentist will attempt to repair tooth damage in numerous ways, depending on the extent of the damage. That can involve fillings, crowns or even root canal treatment. Gum problems — because they are so sneaky and quiet — often are overlooked. Repair can be pretty invasive, including surgery. In health terminology, we refer to reparative procedures as tertiary care. More on that in a moment.
All these repairs are costly because they involve work by a general dentist or dental specialist who has gone through time-consuming, intensive, and very expensive education to perform specialized types of hard-tissue (your teeth) or soft-tissue (your gums) microsurgical techniques using the very best instruments and materials in an extremely clean environment. And, of course, you would not have it any other way.
But it does not have to cost that much. No, I do not mean by getting dental insurance discounts on treatment. High quality dental treatment means a high overhead of costs for the ethical doctor. Deep discounts require cutting corners somewhere in your treatment, and I will let you guess what that means. Actually, it generally means more expense later.
Recall what was mentioned above. Tertiary care is reparative, and repairs are very costly. Why not do something that would avoid those repairs? We know bacteria are the cause of almost all dental problems. If we could only prevent those bacteria from collecting and setting up shop where they do damage, we could prevent the need for repairs!
Prevention is called primary care, and prevention is dirt cheap. Unfortunately, it also requires your dedication. The low-tech toothbrush is the single best invention for doing most of that by disrupting that bacterial plaque from causing trouble. But a brush only cleans half of each tooth. Floss must clean the other half. You must do both, because anywhere you miss cleaning, bacteria will set up shop, grow bigger, and eat and etch to their way to those costly repair procedures. Just insist you have great coaches to train you how to do it well and effectively — your dentist and dental hygienist.
So, why is your dentistry expensive? Because you did not clean off those bacteria. So, get cracking and break out that brush and doggone floss. Every. Single. Day. Because those bugs are sure hoping you’ll leave them alone to feed on you. And to borrow from Smokey the Bear: Remember, only YOU can prevent tooth decay.
Dr. Boden is the FDA president and can be reached dboden@bot.floridadental.org.
Beyond the Bite 