Teeth by Mary Otto

Author:Mary Otto
Language: eng
Format: epub
ISBN: 9781620972816
Publisher: The New Press
Published: 2017-02-26T16:00:00+00:00

8

The System

BY FRAMING DENTAL WORKFORCE QUESTIONS AS MARKETPLACE issues, the Federal Trade Commission has lent its formidable voice to debates roiling dental boards and legislatures in states across the nation. In addition to its work in South Carolina, the agency challenged dental leaders in Louisiana who lobbied to shut down a mobile practice delivering care to children in schools. It advocated for independent-practice hygienists in Maine. Yet some dental groups continue to defy the powerful agency. They insist they are not acting out of self-interest. They say they are protecting Americans from second-class care.

In 2016, the FTC waded into the debate in Georgia—a state with roughly 150 federally designated dental professional shortage areas. Dental hygienists were fighting for legislation that would have allowed them to provide basic preventive care in nursing homes, schools, and public health clinics without a dentist being present to offer “direct supervision.” The FTC wrote in support of Georgia House Bill 684, reminding state officials that only 27 percent of state residents were getting dental services. The measure would lead “to increased access and more cost-effective care, especially for Georgia’s most vulnerable populations,” the agency noted.

Advocates were heartened and hopeful that the legislation would pass. Amendments were added at the request of the Georgia Dental Association (GDA) and the bill continued to move through the legislative process. But when it reached the House Rules Committee, it died a sudden death. Advocates charged that the state dental association had worked behind the scenes to get it killed.

In a statement, GDA executive director Frank Capaldo provided a familiar explanation. He said that, ultimately, dental leaders turned against the bill out of concern for patients. “Why did the Georgia Dental Association, after making suggestions for numerous amendments, change its support on Georgia House Bill 684 when it reached the House Rules Committee? Simple! At the end of the day our member dentists could not compromise their first order of ethical care, to do no harm—as would have inevitably resulted from patients believing that a cleaning was the same as an exam. Yes, the passage of HB 684 would have benefited many dental practices financially who could have deployed unsupervised hygienists to provide cleanings to Medicaid patients. Instead, to their selfless credit, dentists chose the safety of the most vulnerable citizens of Georgia over themselves,” Capaldo noted.

The highest-profile faceoff between the FTC and the dentists in recent memory had nothing to do with the efforts of licensed oral health professionals to deliver preventive dental services to poor schoolchildren or suffering nursing home residents. The fight concerned something on the opposite side of the dental coin—retailers who were opening up teeth-whitening booths in suburban spas and shopping centers.

Teeth can be stained by foods, drink, tobacco use, and aging. Bleaching treatments consist of applying peroxide-containing preparations, which employ chemical action to lighten the enamel and dentin layers of the teeth. Teeth whitening commands a multi-billion-dollar share of America’s market for cosmetic dental goods and services.1 Do-it-yourself teeth-whitening kits are sold in pharmacies. No prescription is needed.

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