For American dentists, times have never been better.
The same cannot be said for Americans’ teeth.
With dentists’ fees rising far faster than inflation and more than 100 million people lacking dental insurance, the percentage of Americans with untreated cavities began rising this decade, reversing a half-century trend of improvement in dental health.
Previously unreleased figures from the Centers for Disease Control and Prevention show that in 2003 and 2004, the most recent years with data available, 27 percent of children and 29 percent of adults had cavities going untreated. The level of untreated decay was the highest since the late 1980s and significantly higher than that found in a survey from 1999 to 2002.
State boards of dentists and the American Dental Association, the main lobbying group for dentists, have fought efforts to use dental hygienists and other non-dentists to provide basic care to people who do not have access to dentists.
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.
“Most dentists consider themselves to be in the business of dentistry rather than the practice of dentistry,” said Dr. David 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.”
Outside the U.S., more than 50 countries now allow technicians called dental therapists to drill and fill cavities.