Wednesday 20 June 2012

The Media Hates on Dentists- Again.

I actually think I am going to end up being a grumpy ranter type blogger. Too many things are getting on my tits at the moment.....

Once again the media are having a crack at dentists in NZ for being prohibitively expensive.
The extreme examples flooded the talkback shows, and dentists get hated on for driving nice cars (I don't, mines a 2004 Subaru station wagon) and sending their kids to private schools.


Kevin from Timaru phoned Danny Watsons show on Newstalk ZB on Monday afternoon to crow that he hadn't needed to go to the dentist since 1967 as he had no teeth left and was still wearing the same set of dentures. Good on you Kevin- dentistry as a science has moved on somewhat since 1967, but I'm glad you can still eat apples. I really hope there isn't any fungal infection or precancerous lesions underneath your 40 year old dentures.


Steve from Auckland (it must have been Auckland) has spent $78K on his teeth. He must be consenting to extensive specialist treatment, I have never even come close to charging one person even a quarter of that amount.


Then we get treated to stories about how great and cheap dentistry is in Thailand and you get a nice holiday to boot. Interestingly, there weren't many stories from callers who had been to Thailand and had dodgy dentistry done, only to have to have it put right once they came home.
Its interesting because I regularly see people who have had disastrous dentistry done overseas. Many have had inappropriate, rushed treatments (you really can't do a smile makeover in a week), no followup care or education on how to care for their new smiles.


Not one single person put their hand up and admitted that they themselves may have been partially to blame for the state of their own teeth. Reminder: dentists don't put disease (decay/ gum disease) into peoples mouths. That gets there through poor habits/diet/education/neglect......we're just the messengers.


I'm going to borrow a couple of quotes from my colleague Andrea who blogs about dental issues here

"Preventative dentistry isn't really that expensive.   A visit to the hygienist costs about the same as a cut and colour for most women at the hairdresser.   Reparative dentistry (who owns the cavity here) is inevitably more costly but think about that for a minute...a porcelain restoration costs anything from $1400 - $1850 depending on the type, locality and dentist delivering the care.  Most dentists put that restoration in with care and dedication, to a high clinical standard and feel comfortable telling their patients that they could expect it to last 10 years or longer in a well maintained mouth.
Your tooth is going to drive the equivalent of 400,000 km over that time as it chews, talks, helps you stay young and healthy because you can eat good food. What else can you buy for $1500 that will last you 10 years - not a TV, nor a computer, or a car.  Your car depreciates and needs maintenance, your computer and TV are out of date in 3 years."

To be a dentist in NZ requires expensive training and equipment- if people are paying, they quite rightly expect the dentist to be up to date with latest techniques and materials to be available to them.
This is Andreas take on it (she does practice in Auckland)...


"If you've got a sore tooth I can pull it out - the simple cheap option for about $300.  Expensive!  Well....  my $50,000 receptionist will take your phone call and fit you in quickly to my spare $80,000 surgery because you're in pain.  I'm assuming you found us on the Internet Yellow Pages after our $3000 ad placement.  I'll take my $400,000 education and diagnose your problem, talking with you in English and know about that new medication you're taking as a blood thinner because the Dental Council requires me to be up to date.   I'll use my $250 forceps. Not to mention my $900 Dental Council Registration fee just to reassure you I'm a properly licensed dentist,  my $400 xray license and my $50,000 xray machine to check that I'm not going to leave you permanently numb after tearing your nerve because your tooth root is wrapped around it.  And it would be good to have a $50,000 dental assistant to help out so you don't have to suction your own blood because I've only got 2 hands.  Remember she's trained to sterilise those forceps in a $10,000 autoclave so you don't contract hepatitis from inadequately sterilised instruments.  How much would you like to pay?
Oh, but you want me to save it with my high tech root canal equipment, my nickel titanium files in my $3000 handpiece (this is not a $200 Dremmel from Bunnings afterall), my modern resin sealers and then use my $200,000 camera and CAD milling equipment to make you a nice white crown that looks like a real tooth.  Sure.  Expect to pay a little more."

At the end of the day, people have a choice about where they want to spend their money. Living in NZ is expensive- overheads here are high, the cost of living is high. Lawyers and accountants are expensive, but they rarely get the amount of vitriol and hate directed them as dentists do. Private medicine is expensive- I don't know any dentists who drive a Maserati, but there were a couple of them in the staff carpark of the Ascot clinic when I was there a few weeks ago.
Beauty therapy, high end fashion and hairdressing is expensive relative to the amount of training and knowledge required to work in those industries, but people are happy to pay through the nose for the perfect haircut and colour or divine pair of shoes- myself included.
I value my hairdresser, he does a great job, and I'm happy to pay for it. The few times I've been to a bargain basement hairdresser I've needed a paper bag to cover the disaster- and ended up paying twice to get it fixed.
Yet people expect dentists to be cheap AND do a great job....


I personally as a dentist will always try to make my treatment plans as affordable and flexible as possible, without compromising the treatment or cutting corners. I invest large amounts of time talking to people about how they can improve their oral health at home. I take pride in my work, and will happy repair/replace/fix/change things on the rare occasions my patients aren't happy with them.


I am sick and tired of being a verbal whipping bag for people who haven't prioritised their own oral health, and now expect me to deliver it to them on a plastic plate...for nothing..




Rant over.