Fixing Denti-Cal and children's teeth

Teeth are important. They can also be a source of problems, as almost everyone has personally experienced. Bad teeth can lead to a lifetime of pain and expense. Medical scientists believe tooth decay and gum problems often have bad secondary effects on health, including causing heart disease.

If makes sense to make sure that all children's teeth are kept healthy. The costs to themselves and society become far higher when problems are allowed to grow over time. That is the reason everyone should support Denti-Cal, the State of California's program to make sure that all children of California have access to professional dental care.

Unfortunately the program currently has some major flaws according to the L.A. Times [See Overdue for Checkups]. There is the usual problem of people failing to enroll. But even of those families enrolled, less than half of the kids see a dentist in any given year.

Even children with good (low sugar) diets who have been taught good dental hygiene practices may end up with tooth decay. Once a year check ups should be a minimal requirement.

There are two major variables to this problem: parents and dentists.

Parents can be encouraged to make sure their kids get dental appointments by requiring the once-per-year checkup in order to continue receiving state benefits themselves. That does not seem like much to add to the checklists of welfare counselors. It may not be a bad idea to require this of parents whether or not they receive welfare.

But apparently part of the problem is dentists who are used to charging their patients more than California will pay under this program.

According to the State Auditor's report, there are entire counties in the state where no dentists will take a Denti-Cal patient (child or adult). And of course such dentists are common enough in every county.

Dentists are licensed by the state. They are able to keep the prices they charge high because the state keeps unlicensed people from performing dentistry.

The solution is simple enough. Divide the population of the state by the number of Denti-Cal recipients. Require each dentist (or dental group) to accept Denti-Cal patients until they have reached this percentage. Dentists who are above the percentage would have the option to lower their percentage, if they wish.

It is possible that this rational plan could create a shortage of dentists, or force many dentists to work longer hours than is fair (because is would add so many patient-visits). In that case the State of California should expand its dental schools and offer scholarships to aspiring dentists if they are willing to work in areas (for some period of time) where there are known shortages of Denti-Cal providers.

Dentists are not licensed to mint money. They are licensed to perform a service for the public. If they do not serve the public, they should not be licensed.

This plan is easy, it is rational and it will be opposed by dentists who are in it just for the money. They will scream, they will pay lobbyists to defeat any such plan. Pass the plan, take away their licenses and let them rot like the teeth of children they neglect.

And once all is well with Denti-Cal, perhaps the other states can follow our example.