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Dental Reform is Needed - Now & Nationwide
State Board of Dentistry
Post Office Box 2649
Harrisburg, PA
17105-2649
CC: Schwartz, Allyson Y. U.S. Representative, 7219 Frankford Avenue, Philadelphia, PA 19135
RE: The Dental Industry Reform Request
Dear Representative
Purpose:
The purpose of this request for Dental Industry Reform is to bring to your attention the dire need for a law changes that will provide tens of millions with more efficient dental health care than what the industry currently provides.
Reason:
Currently millions of Senior Citizens are on Medicare and Social Security, and these safety nets help in providing a safe and healthy existence after retirement, but within this demographic there are millions that have no means of obtaining low cost eye or dental services, which is leading to more serious health issues, of which many are life threatening. Millions of American citizens that are not of the age of retirement also fit into the category as many have poor or no jobs, or are otherwise not covered by any form of dental insurance.
Clinical Studies:
Poor dental health can lead to gum and jaw bone disease that can lead to diabetes complications, Bacterial Pneumonia, Osteoporosis, Cardiovascular Disease (Heart failure and Strokes), and low/extreme birth weighs. The loss of teeth or having teeth with cavities, chipped or broken teeth, etc., make it difficult to chew and properly digest foods that can lead to malnutrition, stomach and intestinal problems, and possible problems with constipation, which can lead to other medical conditions.
Socially:
The failure of society to provide a means of low cost dental care to society as a whole causes various social issues. A person with yellowing, chipped, broken, or missing teeth that is applying for a job will have difficulty obtaining that job just on looks alone. There is also the issue of an employer not wanting to supply employment knowing that the new hire will be subject to raising the company's medical insurance premiums. Added to this is the bad breath that usually accomplices poor dental care, and turns people off, be they an employee or just at a social event.
Record Keeping:
I believe that many areas of the USA do require Dentist to provide their clients with a full set of documentation when the client ask for this documentation. I have been to one Pennsylvania dental college, one Pennsylvania Periodontal specialist, and two local, Mayfair/Philadelphia, PA, dentist and all refused to provide copies of the records and findings that I paid for as a client. This lack of transparency and inter-connective cooperation is costing dental patients valuable time and money in that without a lifelong means of maintaining dental history, tests, x-rays, exams, and such are being needlessly duplicated over and over, and progressive dental and gum diseases are not being found in time to prevent manor health issues.
Electronic Records:
Under the Patient Protection & Affordable Care Act doctors and I believe Dentist have until 2014 to convert all of their client's medical records to digital data media that is or may be easily transferred from medical professional to medical professional. I have found that not one of the four dental establishments visited in an attempt to be helped with my dental conditions have made any moves to convert records, and in fact have told me that they are refusing to do so and will not do so.
One has to wonder the reasons behind the dental community not wanting to provide records to clients or the reasons that they do not want to help their clients with universally available electronic dental records.
Failure to Perform:
Although my case may be unique, I do not believe that it is, especially after talking to others that have had similar experiences.
Example # 1, aging female had family dentist for years and he knew of and watched a lump grew on the roof of her mouth until it finally had to be removed leaving a hole in upper palate and a very expensive prosthesis had to be constructed and now worn; this cancer should have been removed almost two years prior, but the dentist was more interested in his profits than in her health. She ended up having a nervous breakdown and costing her private medical insurance company tens of thousands of dollars.
Example # 2, my personal experiences with the dental community; after two years and $900 in out of pocket expense, I now find that the 'professionals' visited all failed to inform me that I have two molars that are diseased to the point that the jaw bone is now being destroyed under both. This condition showed up on all the x-rays, but the dentist felt that it would be best to make some profits doing simple cleanings, dozens of x-rays, and simple fillings of teeth that were NOT in immediate danger of failure or causing major medical problems.
Example # 3, my personal experience is that even with the recommendation and referral and prescription for dental work, neither Medicare or the VA will accept me for the prescribed and medically necessary dental work.
If you search the Internet you will find thousands of such stories, where failure to inform has resulted in major problems for the clients of these 'professionals'
What is Needed in the Reform:
First part of the Reform should be to make it mandatory for the Dental Community to supply a full copy of a client's dental records, including the x-rays, to the client upon request.
Note that some states like Pennsylvania do have a clause, i.e., 49 Pa. Code § 33.209. Preparing, maintaining and retaining patient records.
"(c) Within 30 days of receipt of a written request from a patient or a patient’s parents or legal guardian if the patient is a minor, an exact copy of the patient’s written dental record, along with copies of radiographs and orthodontic models, if requested, shall be furnished to the patient or to the patient’s new dentist."
The line "furnished to the patient or to the patient's new dentist" should be change to "furnished to the patient and to the patient's new dentist" The reason is that dental records only have to be maintained, or kept, for a period of time and then can be destroyed, and due to the fact that many patients are mobile and move from state to state, thus losing their local dental contacts, and due to the fact that many dentist and dental facilities move or go out of business or change names over time it is necessary for the patient to maintain a copy of his or her records.
Additionally, the requirement to supply records to the client is not being followed by the dental community, and in many instances is being flatly refused by the dentist or dental establishment, including in Pennsylvania. Patient's should be allowed to complete a simple form at the time of service and receive his or her documents immediately, before leaving the dental facility.
Second, is to make it mandatory that clients be provided with a written description and estimate of the procedures that need to be performed, and the recommended priority of the procedures that will result in protecting the client from additional damage or health issues. We require this of construction contractors, but not of our medical professionals, which truly does not make sense, and is costing the medical insurance industry billions in needless claims.
Note that some states like Pennsylvania do have a clause, i.e., 49 Pa. Code § 33.203 (relating to advertising). § 33.203. Advertising. " (2) Treatment planning. A written statement of treatment recommendations following an examination and diagnosis. This statement shall include an itemized treatment recommendation and an itemized fee statement" but is not being followed by the dental community, and in many instances is being flatly refused by the dentist or dental establishment.
Third, is to make it mandatory that all dental records be digitized by 2014 and that the digital copies be made available to every licensed dental care facility in the USA and abroad as needed and authorized by the clients.
Fourth, is to make it a felony for any dental examiner to falsify dental records in an effort to cover up his or her failure to properly perform his or her duties to the clients, this includes not informing a client of possible oral cancers, or major health complications.
This should be a part of the 49 Pa. Code § 33.211. Unprofessional conduct.
" (a) Dentists. Unprofessional conduct, as defined in section 4.1(a)(8) of the act (63 P. S. § 123.1(a)(8))" and similar other state codes.
Currently, there are fines and suspension or elimination of a license for Unprofessional Conduct, but in this specific instance, i.e., cancers or major health complications that can lead to death of the client, the action MUST be considered a Felony and treated in the courts as such.
Fifth, is to make it a requirement of any government assisted student loan for dental schooling that the person receiving the schooling must spend twenty hours of community service per year for the first three years after graduation doing oral care for the citizens of the community in which he or she resides or in the service and name of the USA in a foreign nation or territory such as Haiti, or on an Native American Indian Reservation.
Sixth, is to make it a mandatory requirement that all dental professionals attend at least one course in new techniques and procedures every two years. Many states have some continued education requirements, some do not. See http://www.ddstraining.com/dental-ce-by-state . There does not appear to be any national or state wide 'standards' for this continued education.
Seven, is to have an authority or agency that can make unannounced visits to dental offices for inspection of procedures, cleanliness, licenses, and documentation. Currently, announced visits are authorized, and this allows time for preparation and may result in a waste of time for the inspector and the public's interest and funding.
Eighth, if the Patient Protection & Affordable Care Act is constitutional and to be placed into effect, then it should be mandatory for Dental Facilities to digitize patient's records and to provide such records to the patient and his or her medical or new dental facility, upon request via a simple Records Request Authorization Form, that only needs signature and date.
Nine, Medicare and the Veterans Administration Medical facilities should be authorized to intervene upon request of a patient and take care of major dental conditions that may result in severe medical complications to the patient. Recommendations and referrals and prescriptions from a qualified licensed dental professional MUST be honored.
Thank you,
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