Preventive dentistry ‘does not pay’

Press, 2 December 1978, Page 23

Preventive dentistry ‘does not pay’

1 'The Health Department pay dentists to drill holes in teen-agers’ mouths; it does not pay to stop the holes appearing,” say Christchurch dentists. They say they are prepared to spend more time doing preventive dentistry on adults than on secondary school children, because they make more money working on adults.

The problem is what s known as the Dental Benefit Scheme. This scheme, administered by the Health Department, makes a payment to dentists on the basis of certain categories of work done on the teeth of youngsters aged between 13 and 16, and in some cases, up to 18 years.

But the scheme does not pay dentists for work done to prevent decay starting. If a dentist wants to fluoridate a young person's teeth, seal fissures to prevent decay, or instruct in oral hygiene, he pays for it himself. Parents would strongly resist any charge for that work, dentists say. The scheme pays a set rate for examinations, extractions (because of decay, not for orthodontic

purposes) and fillings. Some dentists say the fees are barely adequate. Their normal charge-out rate is $35 to $4O an hour; under the scheme it becomes about $l5. But although dentists say that the dental benefit scheme is inadequate and outdated, they have so far resisted an alternative that arose several years ago in their own ranks, and had the backing of the Health Department. It was that the department would give a grant dentists once a year simply for the all-round care of teeth of school pupils on their books.

The principal dental officer with the Health Department in Christchurch (Mr H. B. Drinnan) says the grant would probably reflect the differing amounts of dental care required by pupils in diff e r e n t socio-economic areas, and might be based on the previous year’s dental record. This scheme would, ideally, financially motivate dentists to do a little more for the teeth than “knock out enamel and throw in amalgam.” There is talk by the Dental Association of another look at the scheme after the Association’s

executive rejected it about five years ago. Mr Drinnan says the next move is up to the association, because without its sanction, the department has no mandate. Certainly, unless changes are made, schoolchildren will continue to lose teeth they should be keeping. Dentists are not happy about a grant based on pupils’ dental records for the previous year. They say this might tempt dentists to over-fill mouths one year to increase the grant for the next year. Their next objection may have to become a capitulation, because the Christchurch City Council does not seem about to introduce fluoridation.

Dentists say they would prefer the grant scheme to be introduced after citywide fluoridation has evened out the wide * * s o c i o-economic” variations in dental health. Fluoridation — “dental care while you sleep” — would reduce the chances that dentists serving poorer areas might be left further out of pocket than dentists serving better areas, where parents tend to enforce the cleaning of teeth and the taking of fluoride tablets.