Oral Health Group

Dental Coverage Could Impact Your Patient Treatment Acceptance

May 7, 2018
by Shawn Peers, DentalPeers


“Selling” treatment is a challenge for many dentists. Treatment can be costly and it is not easy to convince some patients there is value when they do not “feel” they have a problem.

Bottom line…bleeding gums are not a big problem if there is no pain or discomfort…right?

Even with an employee benefit plan covering some of the expenses for treatment, many patients are resistant to picking up any difference. They want to believe the profit motivated, insurance “desk jockey”, with no dental training who tells them they do not require your prescribed treatment. After all, no treatment means the patient saves money on the co-pay…in the short term.

This begs the question…could this become a bigger problem as dentistry moves into our non-profit driven, Canadian universal health care system?

Political debates aside, it seems inevitable that dentistry will find its way into the single payer system. In Ontario, two of the three major political parties have included this as part of their platform for the upcoming June election.

Now the Wynne government proposal is woefully inadequate. It would provide 80% coverage up to a maximum of $400 annually for a single person, $600 for a couple and an additional $50 for a child. Plus those amounts are lumped in with a universal drug plan

The NDP has argued for more money to provide more meaningful coverage.

My question is by including some dental coverage under our cherished health care system, will it become harder for dentists to convince patients of the value of treatment that exceeds any government maximums?

Even if the proposed plan more closely reflected the limits of existing private plans, additional coverage for patients requiring 3 or 4 visits annually for preventative maintenance may not be readily available. If the government, is unwilling to fund all treatment, will patients be less likely to follow more costly recommendations from their dentists?

Value is the motivating factor. Patients suffering from a dental abscess value the treatment that alleviates their discomfort. However, it is harder to get them to value treatment that could prevent that painful abscess in the first place. Such appointments are essentially a form of screening designed to provide early detection of more serious oral health concerns.

So let’s compare how Ontarians respond to other forms of preventative health screening…such as breast cancer screening, a “free” service provided by the Ontario government. Women between the ages of 50 and 74 are advised to have a mammogram every 24 months. Yet statistics show that approximately 80% of eligible Ontario women have one every 30 months. That means 20% are not getting one at all and some are overdue by as much as 6 months.

The consequences of breast cancer are well known, as are the benefits of early detection. Yet many women will be late for their screening or will not attend at all. How, then, can we expect patients to value a dental appointment that is not fully funded and which they perceive as little more than a “cleaning”?

The challenges could be interesting to watch. One thing that seems certain…dentists may have to “up their game” if they want to sell patients on necessary treatment that is not covered by any government plan.

And you thought it was hard to convince them when it was a “for profit” insurance company you had to contend with!