A Visit to the Dentist

It started with a visit to the dentist. I had a painful dental abscess and a swollen jaw. I needed help, and I got it - a digital x-ray to identify the source of the problem, a prescription for augmentin, and advice to have two teeth pulled when the swelling subsided. This was no root canal visit.

It was a two man practice with 11 employees. The visit was pleasant, entailed little waiting, and involved current technology, including a digital x-ray, which was printed on the spot.

The dentist was courteous and competent, and his staff was happy and in a festive mood. Both the dentist and his employees were dressed in their Halloween garb.

This encounter got me to thinking about dentists and doctors. Dentists are mostly in small practices. They tend to be independent entrepreneurs. They are relatively untouched by third party insurers. Most dental insurance policies are capped at a $1000 or $1500. Most doctors are paid fee-for-service, often before leaving the office.

Dentists in general practice on average make more money than internists, family physicians, psychiatrists, and pediatricians. Not much more, 5% to 10% more, $180,000 vs $160,000, in that range. And dental specialists – oral surgeons and periodontists – make roughly the same as most medical specialists, $250,000 to $400,000. I do not begrudge dentists’ incomes. They deserve what they get. Their educations require 3 or 4 years of college, 4 years in dental school, 2 to 3 years more if they specialize.

Dentists are fortunate in not having the fact the heavy overheads and accounts receivable imposed by third parties, especially Medicare which pays about 30% less than private insurers. Dentists also work an average of 40 hours a week, versus 55 to 70 hours for most primary care doctors. Dentists have few emergencies, no night calls, and few emergency room calls.

In addition, dentist malpractice rates are lower. Dental diseases are rarely fatal, and even when they encounter an oral cancer, they can refer to specialists.

Besides, dental mistakes are more obvious and can rarely be hidden. All one needs to do is look into the mouth to see what has or has not been done and whether it has been done properly.

Medical diseases, on the other hand, tend to be more mysterious, hidden, and elusive to diagnose. Maladies can lurk anywhere in the body, often in inaccessible places and cavities, or they may be systemic, involving every organ. With medical care, there is more room for error, and for severe consequences of misdiagnosis and surgical missteps.

Much of what dentists do is optional or cosmetic , varying from braces, to implants, to crowns, to dentures – and positively contributes to better appearances.

I am sure being a dentist has its pitfalls, pratfalls, and beartraps. But dentists relieve pain, create beautiful smiles, and leave satisfied patients in their wake. Theirs is a noble profession. For many dentists, these are the good old days. I salute and applaud their success.