Magazine laments inequality of smiles

U.S. dentistry is "in a dire state," according to the writer of a seven-part series on the subject in the online magazine Slate this month. Serious flaws in the oral health care system have resulted in gross inequities, concludes writer June Thomas.

The series' title "The American Way of Dentistry," evokes a 1963 journalism classic, "The American Way of Death," in which British immigrant Jessica Mitford uncovered unscrupulous practices in the U.S. funeral industry.

In the Slate series, Thomas begins by describing the appalling lack of care her own teeth got when she was growing up in England. But the problem there, she writes, wasn't lack of access to care but simply a lack of interest. "When I was a kid, anyone could get an appointment to see a National Health Service dentist, and there was no out-of-pocket cost for treatment. Still, in my working-class community Manchester, perfect teeth were seen as a bit of an affectation."

After moving to the U.S., Thomas writes, and getting dental benefits through her employer, she launched into extensive dental work, but even with the insurance ended up spending over $45,000 of her own money. The experience led her to wonder what would happen to someone who couldn't afford such expenses and to conclude that too many people in the U.S. simply can't get the oral health care they need.

In the fourth part of the series, "How Dentists Think," she argues that dentists aren't very motivated to rectify the inequities. "With a limited number of appointments available and -- for many dentists -- enough full-fee patients to fill the slots, there's little incentive to serve the low-income people who need them most."

A big part of the problem is a shortage of dentists, she concludes, and little is being done to correct the problem.