As reported by the Wilmette Life, October 4, 2007.

Dentists Work Harder than Ever, Even as Patient Health Improves

By Ruth Solomon

Many middle- and upper-income parents of today's younger children may be shocked to hear of that toothpaste commercial from the '60s when the child runs in breathlessly and exclaims:

"I only had one cavity!"

The fact is that fluoridation of water, rinses and toothpaste and improved preventive measures by dentists have dramatically lowered the number of cavities children have. Many have no cavities -- ever.

In fact, tooth decay in permanent teeth has decreased not only for children and teens, but also adults, according to an April 2007 release from the National Center for Health Statistics.

And dental insurance benefits for employees have meant more Americans have been going for routine cleanings that could prevent more costly restorations.

So aren't dentists hurting as a result of their own success?

Dentists did, in fact, experience a decline in income in the 1980s. Partly due to this drop in income, the number of graduates from dental schools dropped, from 6,500 to 4,000 per year.

But projections are that the population will grow at a greater rate than the number of new dentists, continuing on until the year 2020, according to the American Dental Association and the Bureau of Health Manpower. This will put upward pressure on dentists' income.

In fact, the income of general practitioners of dentistry, which was about $160,000 in 2000, now eclipses that of general practitioners in medicine, whose incomes were closer to $145,000 to $150,000, the figures showed. Specialists in medicine and dentistry, however, are about the same. In 1990, general practitioners of dentistry earned less than their medical counterparts, the figures showed.

New services to patients

And as it turns out, dentists are still working just as hard as ever, just in different ways.

With less work restoring teeth, they are performing other services, including diagnosis, prevention and cosmetic dentistry, said Howard Bailit, a professor at the University of Connecticut School of Medicine. Bailit, who has a dental degree from Tufts and a doctorate from Harvard, was speaking at a 2004 Society of Actuaries conference in Anaheim, Calif.

Several pockets of the population also stand out as needing more attention to their teeth. Tooth decay in baby teeth of children ages 2 to 5 has actually increased, the April government report stated.

And a total of 12 percent of children in families with incomes less than the poverty level had untreated tooth decay compared with 4 percent of children in families with incomes greater than the poverty line.

As in any field, dentists are more likely to congregate where they can earn a living, Bailit said at the conference. In the United States, that largely means in middle- and upper-income communities.

That could change, however, if dentists could earn comparable incomes for servicing low-income families paid for by government programs such as Medicaid and state children's health insurance programs, he said.

Dentists also stand to profit from the aging baby boomer population. Unlike previous generations, the baby boomers are much more likely to enter their senior years with most or all of their teeth. Demand is growing for dental services by older adults, according a report by Mark W. Stanton for the Agency for Healthcare Research and Quality.

In addition, more attention to cosmetic dentistry, including teeth whitening and straightening, may provide another source of revenue for dentists.

"(I)mproved oral health does not decrease the rate of growth in expenditures," Bailit said. "Better oral health does change the mix of services patients receive."