The most controversial trends in dentistry

The increasing power of corporate dental groups, the popularity of at-home clear aligners and low reimbursement rates are among the most controversial trends in dentistry. 

Three dentists recently spoke with Beckers about why they consider these trends controversial and their effects on the industry. 

Editor's note: Responses were lightly edited for clarity and length. 

Marian Bradford, DDS. Premier Dental of South Orange County (Aliso Viejo, Calif.): The most controversial trend in dentistry today remains the at-home aligner therapy that continues to gain popularity due to intensive marketing campaigns by the companies and the strong social media influence that these companies pay to have. The idea that orthodontic treatment can be completed by a patient at home with very little to no supervision by a general dentist trained in aligner therapy or orthodontist is questionable at the very least and malpractice in other situations. I have personally treated patients that started orthodontic treatment with at-home aligners only to have the treatment fail in achieving the patients' goals or worse, cause malocclusion, TMJ dysfunction and periodontal issues. It is astonishing that [the American Dental Association] or state dental associations have not stepped in with a campaign to educate the public on the marked deficiencies and misleading practices of these at-home aligner companies. 

Peter Perera, DMD. High Mountain Dentistry (North Haledon, N.J.): Honestly, for most of us general dentists working our practices, dental insurance reimbursement schedules are our biggest concern and the dilemma of whether to accept a particular plan or not may swing hundreds of patients in or out of your office. There are dozens of more exotic, flashy topics to call controversial, but most of those don't affect most of us day in or day out. Having to write off 30-40 percent of our fees when the insurance companies are charging more for premiums and paying out less in benefits is about as controversial as it gets.

Charles Rim, DDS. Oregon State Hospital (Salem): One of the most controversial trends in dentistry today is the paradigm shift of dental practice patterns across the nation. The classical solo dental practice is becoming less of a common path for new graduate dentists due to multiple factors, including high education loan obligations, rising supply and ancillary staff costs, limited insurance benefits, lifestyle choices and fierce competitive market challenges. An optional pathway for the new generation of dentists is working in a corporate dental practice where the quality of care can be impacted by the corporate business model with restricted individual provider autonomy of rendering dental services. With the current stimulating dental industry environment, one must contemplate about the societal, financial and ethical issue of emerging dental practices to navigate through the complex healthcare system.

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