Differences Between Medicine and Dentistry Drive Plan Design

Medicine and dentistry have many differences, and sound dental plan design recognizes these. These differences include practice location, the nature of care, cost, and emphasis on prevention.

Location

The practice of the typical physician is hospital-based, while many dentists practice almost exclusively in individual offices. Partly because of these practice differences, physicians tend to associate with other physicians with greater frequency than dentists associate with other dentists. This isolation, along with the inherent differences in the nature of medical and dental care, tends to produce a greater variety of dental practice patterns than is the case in medicine. In addition, practicing in isolation does not afford the same opportunities for peer review and general quality control.

Nature of Care, Cost, and Prevention

Perhaps contributing more significantly to the differences in medicine and dentistry are the important differences between the nature of medical and dental care.

First and perhaps foremost, because of the importance of preventive dentistry, the need for dental care is almost universal to ensure sound oral hygiene. Many individuals sometimes require only preventive or no medical care for years. Individuals routinely visit their dentists for preventive dental care, but in medicine the patient typically visits a physician with certain symptoms—often pain or discomfort—and seeks relief.

Dental treatment, because of its emphasis on prevention, often is considered elective. Unless there is pain or trauma, dental care is sometimes postponed. The patient recognizes that life is not at risk and as a result has few reservations about postponing treatment. In fact, postponement may be preferable to some patients—perhaps because of an aversion to visiting the dentist, rooted many years in the past when dental technology was less developed.

Because major dental care is not life-threatening and time-critical, dentists' charges for major courses of treatment often are discussed in advance of the treatment when there is no pain or trauma. As with any number of other consumer decisions, the patient may opt to defer the treatment to a later time or spend the money elsewhere.

A second difference in the nature of care is that, while medical care is rarely cosmetic, dental care often is. A crown, for example, may be necessary to save a tooth, but it also may be used to improve the patient's appearance. Many people place orthodontics into the same category, although evidence exists that failure to obtain needed orthodontic care may result in problems ranging from major gum disease to temporomandibular joint (TMJ) disorders in later life.

A third major difference between the nature of medical and dental care is that dentistry often offers alternative procedures for treating disease and restoring teeth, many of which are equally effective. For example, a molar cavity might be treated by a two-surface gold onlay, which may cost 10 times as much as a simple amalgam filling. In these instances, the choice of the appropriate procedure is influenced by a number of factors, including the cost of the alternatives, the condition of the affected tooth and the teeth surrounding it, and the likelihood that a particular approach will be successful.

There are other significant differences in medical care and dentistry that will have an effect on plan design. These include the cost of the typical treatment and the emphasis on prevention.

Dental expenses generally are lower, more predictable, and budgetable. The average dental claim check is only about $139. Medical claims, on average, are much higher.

The last significant difference is the emphasis on prevention. The advantages of preventive dentistry are clearly documented. While certain medical diseases and injuries are self-healing, dental disease, once started, almost always gets progressively worse. Therefore, preventive care may be more productive in dentistry than in medicine. Certainly the value of preventive dentistry relative to its cost is acknowledged.