A New York Times article tells of the rise of untreated cavities due to lack of access to dentists.
Anyone who has followed the debate about what the correct number of physicians in a medical market should be will find this discussion familiar. On the one hand, there is an obvious lack of services for some communities, especially the poor, but not only the poor. On the other hand, the professional organization representing the supply side (here the American Dental Association) fights tooth and nail against any attempts to increase the number of providers to bring down the price and to increase the availability of the services. These professional organizations also oppose the use of paramedics or the equivalent dental profession: dental therapists, in the performance of some limited services. Dental therapists, for example, are used to drill and fill teeth in some countries. But the American Dental Association doesn't like them:
"What we're extremely uncomfortable with is that they need to drill teeth and sometimes extract teeth," said Dr. Roth, the association's president. Use of therapists would create a two-tier system where some people have access to dentists, while others must settle for less-qualified practitioners, she said.
Dr. Roth seems to criticize the dental therapist proposal by comparing it to an imaginary ideal situation. In reality, the current two-tier system is one in which some people have access to dentists, while others have no access at all. I would think having no access is at least as risky as having access only to less-qualified providers.
Organizations such as the AMA (the American Medical Association) and the ADA are ultimately trade unions for their members. This gets forgotten because of the other roles these organization serve. The ADA is protecting the interests of their existing members, and this requires controlling the number of new dentists who are allowed to practice as well as restricting any competition in the dental care markets.
-- J. Goodrich