What are lawmakers thinking?

Jul 12, 2010

Editor's note: Helaine Smith's column, The Mouth Physician, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

As of July 1, the state of Massachusetts no longer offers many adult dental benefits through its MassHealth program.

As part of the $800 million in cuts made to the state's 2011 budget, some 600,000 adults in Massachusetts will lose their access to routine dental care other than cleanings, extractions, and emergency services. All restorative procedures, including dentures, fillings, root canals, crowns, and periodontal work, will not be covered.

Why didn't the local dental society advocate for the importance of keeping these benefits?

I do not understand the logic of this. We know it will only cause more harm to those who truly need help. The state of Massachusetts -- where I live and practice -- has a history of making cruel decisions that negatively affect those who cannot help themselves. In the 1980s, for example, several state-run hospitals for people with mental illnesses were closed, literally forcing many patients onto the streets of Boston.

It seems our "educated" lawmakers still consider dental health a nonessential part of our overall health. The reimbursement the state gave to participating dentists in the MassHealth program was insulting, and the state would not budge on raising compensation.

Also contributing to the problem is the proposal to add midlevel providers to the mix, which some believe will help increase access to care for underserved populations and reduce costs. I have stated in previous blogs that I do not feel it is right to allow less qualified, less educated people to serve the poor. Often the poor are the most complicated cases due to social and behavioral circumstances, and they are usually medically compromised.

The excellent article by Robert Wartell, D.D.S., that recently appeared on Dr.Bicuspid.com was far more eloquent than I could ever be on this topic, and he expressed my sentiments fully. The fact that the dental community in some states is willing to allow midlevel practitioners to perform invasive procedures is appalling to me.

This is a mistake our profession is allowing, and it is not practical or ethical. I guess some dentists still see us as tooth plumbers and will allow someone with no college education do extraction and fillings after an apprenticeship of only 18 months. Once again, they do not know what they do not know, and they do not understand what it means to be a mouth physician.

Helaine Smith, D.M.D., owns and operates two dental offices -- a cosmetic dental spa and a family dental practice -- in the Boston area and is a passionate advocate for educating consumers about dentistry. A fellow of the Academy of General Dentistry, Dr. Smith writes and lectures about dentistry frequently and is actively involved in several volunteer organizations, including Operation Smile, Cape CARES, and Give Back a Smile.

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