Boom Times for Dentists, but Not for Teeth

For middle-class and wealthy Americans, straight white teeth are still a virtual birthright. And dentists say that a majority of people in this country receive high-quality care.

But many poor and lower-middle-class families do not receive adequate care, in part because most dentists want customers who can pay cash or have private insurance, and they do not accept Medicaid patients. As a result, publicly supported dental clinics have months-long waiting lists even for people who need major surgery for decayed teeth. At the pediatric clinic managed by the state-supported University of Florida dental school, for example, low-income children must wait six months for surgery.

In some cases, the results of poor dental care have been deadly. A child in Mississippi and another in Maryland died this year from infections caused by decayed teeth.

The dental profession’s critics — who include public health experts, some physicians and even some dental school professors — say that too many dentists are focused more on money than medicine.

“Most dentists consider themselves to be in the business of dentistry rather than the practice of dentistry,” said Dr. David A. Nash, a professor of pediatric dentistry at the University of Kentucky. “I’m a cynic about my profession, but the data are there. It’s embarrassing.”

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