PBS Frontline Dental Episode

Dental Care PBS

PBS Frontline investigated the nation’s dental care on Tuesday, June 26, 2012 episode titled Dollars and Dentists (watch the episode below). PBS examined the nation’s dental care system by digging into the different methods that try to serve patients and their dental care woes.

Diane Herbert-Farrell, a spokeswoman for “Frontline,” said “The film looks at different states: the state of Florida, some work done in Virginia; we look at several of the models being tried. We look at how are people looking at dental care.”

Sarrell Dental Clinic was one of those different methods being looked at. Jeff Parker, CEO of Sarrell, said “Frontline” camera crew and members spent about 11 hours filming in the Anniston office, interviewing employees, patients and their families. He said, “I’m very pleased they chose us to use as a role model.”

Sarrell Dental has 14 clinics across Alabama and a mobile bus. They are currently the main provider in the state of dental care for children on Medicaid and has had continuous growth since its first clinic opened in 2005. In its first year, Sarrell served 3,500 children. Last year, Sarrell served 105,000 patients and has served 350,000 patients to date, according to the site.

More than 100 million Americans don’t go to the dentist because they simply can’t afford the bill that comes after. Many either go broke trying to pay for the dentist bill or they suffer from extreme pain while going untreated and some even die from the untreated disease.

One in four children have untreated tooth decay, which is now the most common chronic illness among school-aged children. Nearly 5 million American children, or one in 16, did not get a regular dental checkup in 2008 because their families could not afford it, according to a report released last year from the Institute of Medicine.

Kool Smiles Complaints

In 2009, according to the Kaiser Family Foundation data, 19 million children had no dental insurance. Poor children are covered by Medicaid and dentist will turn them away because the profit margins aren’t there. The problem, Medicare offers no dental coverage unless it’s connected to a medical procedure.

The PBS Frontline investigation also found that Kool Smiles, who specializes in treating low-income children, will financially reward their dentists for hitting a high revenue goal and sometimes fire those who don’t.

Kool Smiles denies that they influence dentists to boost revenues and says it offers quality dental care to an underserved population neglected by traditional dental practices.

Aspen Dental was another that PBS Frontline looked at. They are one of the largest for-profit chains that is aimed at adults who haven’t been to the dentists in years. Aspen Dental is a chain of 300 offices in 22 states managed by a company owned by a private-equity firm. It is part of a fast-growing industry of corporate dental practices, many of which specialize in serving people who cannot afford to go to the dentist, a group many dentists ignore, PBS reported.

Aspen Dental chief executive Robert Fontana said, “A typical patient is probably 45 to 65 and struggling just to make ends meet. They’re taking this week’s paycheck to pay last month’s mortgage, making their car payment, trying to put their kids through school and unfortunately, dentistry can become discretionary.”

Aspen Dental Complaints

Aspen Dental denies that its dentists have stronger financial incentives than other dentists or that its bonuses affect treatments. Fontana, founder and chief executive officer of Aspen Dental, says that dentists won’t do unnecessary treatments because it’s just not in their DNA.

Watch the PBS Frontline Dental Episode:

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7 Comments on "PBS Frontline Dental Episode"

  1. My mother goes to a dentist with a substantial office staff – or at least a crowd of young women wearing scrubs behind the main desk. I’m sure her insurance company has legions of office drones. These two groups of medical industry paper-pushers manage to generate one faulty bill after another, even sending re-billings on statements that have already been confirmed as paid in full. They take turns blaming the mistakes on a third company to which the dentist has out-sourced his billing. It’s the most expensive game of Three Card Monty anyone in my family has ever played!

  2. Whatever happened to dentist hygiene? This film shows dentists putting their fingers into patient mouths, then using the same fingers to adjust the lamp, then back into the patient mouths again. Over and over, throughout the entire film, they do this. Unless the lamp handle is sterilized from one patient to the next, the dentist is transferring germs from the mouth of one patient to the mouth of the next. Same thing with the x-ray button, dental tools, and even eye implements that need adjusting. These people touch everything that can be contaminated before putting their filthy fingers in patient mouths. I don’t need to be suffering from OCD to have an aversion to dental-office visits. The last time I was in, the gal dropped the x-ray film on the floor. She would’ve succeeded in picking it up and placing it in my mouth had I not had the peripheral vision to notice and clutch her wrist in time. And that x-ray shield she threw on my lap? It was filthy, way dirtier than the pad my mechanic throws on my car fenders. Imagine how filthy the chair, itself, must be, much less the unprotected head rest! No matter how clean your clothes and hair are going in, you can come away only as clean as the filthiest patient before you. The thought alone makes my skin crawl. And dentist wonder why patients hate to see them or why infections are now epidemic in the health-care industry. What a sorry spectacle of health-care professionalism, infested with people who mistakenly believe that donning rubber gloves makes it okay to touch everything that is not sterilized.

    • Spenser Cammack | July 1, 2012 at 9:51 am |

      The standard set in each and every state requires that all these items be disinfected between every patient that is seen in the operatory. In our office we use a barrier system for the light, chair, x-ray unit, air-water syringe, and suction units (the tips for air/water are replaced and sterilized after each patient, the suction tips are disposed of). The x-ray bibs are wiped down with a heavy disinfectant after each and every use. This may actually be what you see on the bib. They can be discolored by the disinfectant. We keep tract of everything that is touched in the room during the visit, and wipe it down if it has been touched. This includes solid surfaces (wiped down every time anyway), keyboards, monitors, eye wear (providers that is- patient eye wear soaks overnight in a cold sterile bath). We also wear personal barriers that cover from the neck to the knee, as required by WA state. If you have concerns, simply ask your dentist to allow you to watch the room be taken down and prepared prior to you coming in for a visit. This is not a terribly uncommon request. Patient safety and health is the top priority of our office and most out there. You just may not be seeing what is going on behind the scene.

  3. Dr. Doolittle | June 27, 2012 at 3:18 pm | Reply

    On the flip side…..you shut these medicaid practice down because you’ve investigate and interviewed disgruntled employees and guess what…..no one will see these patients……I sure won’t…they can’t afford me and I can’t afford to take a reduced fee.

    They will all end up in the ER costing the govt billions of dollars. What’s the solution…..no idea but your skewed discussion makes us want to vomit. Have another opinion out there besides your own and let the public make up their own mind.

    • I do not think anyone is suggesting that these practices shut down. However, once again free enterprise has trumped the better good. These practices are suffering from a lack of government regulation and tax paying citizens are paying for unnecessary procedures. Unfortunately, this time it is at the expense of children.

      Oh and for the record, I have dental insurance and what I consider a descent dentist. Guess what. To suggest that you cannot afford to take a reduced fee is absurd. Dental fees are unbelievably inflated. Even with insurance, my 20% co-pay on any procedure is a huge kick in the ass. The idea that that a dentist will go broke if he or she consents to or is required to allow a small percentage of their patients to pay with Medicaid reimbursement is laughable. Sorry no one who has ever paid a dental bill thinks, “oh my poor poor self-sacrificing dentist. I sure hope he can pay his house note this month”

    • Spenser Cammack | July 1, 2012 at 10:06 am |


      I understand your frustration with dental fees. Dentistry is a significant investment. What frustrates me a provider is that the law in WA is absurd to cover Medicaid. We have patients of record that are on Medicaid and we gladly see them. I don’t ask for your sympathy, but the reimbursement doesn’t cover expenses, much less pay me anything. We do it because they have been patients, they are kids, and I can’t turn them away (ethically). This state will not allow me to take on a “small percentage” of new patients. Either I take everyone (honestly can’t afford to,cheaper to shut the doors) or I can add no one. I want to see and take on some level of constant new patients that are on medicaid, especially my existing patients that fall on hard times, but the state says they can sue me if I do that. To have any sort of profit margin seeing a large portion of Medicaid, it becomes a numbers game. You have to push them through quickly. That is the only way it is doable. This is not the care I am willing to provide. There has to be a better way.

  4. You failed to investigate, the pervasive practice, how these Medicaid providers uses outside “marketers” to lure patients to these clinics. Basically, the marketers get money from clinics, then “bus” children to these clinics. In return, the marketers offer gift cards and pizza to these families. A major disadvantage for the honest and small offices.

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