Dentistry is in need of major reforms in order to protect the sustainability of practices, according to one dentist.
Krista Kappus, DDS, of Fitch Mountain Dental in Healdsburg, Calif., recently spoke with Becker’s to discuss the changes that would benefit dentistry.
Editor’s note: These responses were lightly edited for clarity and length.
Question: Is there anything that makes you nervous about the dental industry right now?
Dr. Krista Kappus: Every cost has gone up astronomically for us: staffing costs, all of our dental supply costs, rent, everything has gone up, but I do think there needs to be a massive change in insurance for us to be able to provide high quality dental … How are you going to continue to be able to pay and maintain staffing if you’re not getting reimbursed what you need to get reimbursed to make that? That’s certainly scary.
I think it is going to be a little bit of a challenge keeping people around. That’s been the talk among dentists for the last several years. I pulled one article up recently that was from a dental hygiene magazine, and [they discussed how] dental hygienists don’t want to stay around. They don’t want to work right now. It’s a negative workplace culture. There’s insufficient pay. They’re feeling overworked. I think there’s only so much you can do with that. We’re already paying our hygienists to be there. We’re bonusing them. We’re giving them an hour for every procedure, so there’s only so much you can really do before that’s not really the issue.
Q: What changes could be made to help alleviate staffing challenges?
KK: I just think there needs to be a lot of reform in general. Looking at insurance, in the 60s, insurance was truly just, you’d go to the dentist [and] they would reimburse. It’s just shifted and shifted and shifted to where now, we’re getting everything preauthorized before we do treatment. We have a whole separate department just for dealing with insurance. We have different companies we work with for insurance, and it’s just gotten so complicated. Insurance maximums haven’t changed … I don’t know what the changes are going to be, but it’s not going in the right direction for dentists to be able to function.
Staffing wise, there really hasn’t been an increase in dental hygiene programs over the last 20 years. In the state of California, you can have an expanded function dental assistant who can place fillings and can use high-speed hand pieces. They can use low-speed hand pieces, they can put fillings in, but they can’t scale teeth. They can use an ultrasonic cleaner if they’re removing ortho cement, but they can’t scale teeth. Hygienists were there to originally help release the burden on dentists, but maybe there’s a change of expanded function assistants who can do simple cleanings.
I do think we need to have just generally dental education reform [and] insurance reform. Look at dental education. You’re graduating from school with $600,000 in debt. Who’s going to be able to go into the workforce the way it’s going and make $100,000 a year? Make that make sense.
