Pulling Teeth: Admitting Errors in Dental Care Post

In a column posted last month, “The Political Economy of Dental Care,” I suggested that one way to improve the affordability of and access to dentistry services in Virginia might be to reduce the cost of educating dentists. I highlighted the high cost of completing a dental degree at the Virginia Commonwealth University, Virginia’s only school of dentistry. While I still maintain that the cost of attendance is so high that graduates feel compelled to set up shop into metropolitan markets where they can earn enough to pay off their student loans, I got some of my facts wrong.

In the post, I stated that the cost of attending the VCU School of Dentistry runs about $133,000 to $140,000 per year over four years. In fact, according to data published on the school’s website, the cost for in-state students runs between $85,000 and $89,000 a year and for out-of-state students between $114,000 and $119,000 — high, to be sure, but considerably lower that what I stated. (The four-year cost is estimated to be $344,000 for in-state students and $461,000 for out-of-state residents.

Compounding my initial misperception, I also stated that the cost of attendance at VCU was significantly higher than the national average. To the contrary, the School of Dentistry cites American Dental Association (ADA) data to the effect that VCU’s cost of annual D.D.S. education was lower than the national average for in-state students in 2017-18 —  $59,569 compared to $64,305. However, the cost for out-of-state students was somewhat higher — $88,073 compared to $81,939. (I’m not sure how the ADA data is reconciled with the cost-of-attendance figures on the School of Dentistry’s website.)

Thirdly, ADA data contradicts my speculation that Virginia dentists might graduate with higher debt than their peers outside the state. In 2017, the average debt was $162,384 for a VCU in-state student, $207,924 for a VCU out-of-state student, and $239,895 for students at public dental colleges nationally.

I also argued that “dental technicians” should be given freer rein in under-served rural areas to provide dental-related services. Nan Johnson, director of communications for the School of Dentistry, informs me I was using improper nomenclature. The term “dental technician” is not used in the profession. Rather, the classifications of those who work with dentists are referred to as dental assistants, dental hygienists, or dental laboratory technicians.

Finally, I referred to the Virginia Oral Health Coalition as “an alliance representing the dental profession.” In point of fact, says Johnson, it is an alliance “to ensure that all Virginians can access affordable, comprehensive health care that includes oral health.” The Coalition includes not just dental professionals but educators, health care providers, and community members.

I am duly chastened. I think the larger points of my piece still stands — the high cost of dental school aggravates the shortage of dental services in rural areas, and the dental profession’s solution is to increase federal and state spending rather than address the cost side. But it helps no one to employ inaccurate facts. Further, I had no basis for singling out the VCU School of Dentistry as being especially expensive. The high cost of dental education appears to be a national problem.

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4 responses to “Pulling Teeth: Admitting Errors in Dental Care Post”

  1. LarrytheG Avatar

    Perhaps the one thing that trumps almost everything else in a job interview is missing teeth.. Missing teeth is a common denominator among the food pantry clients.. they will have some fashion of a car, glasses, even hearing aids, and a cell phone… but the cost of replacing a pulled tooth is a bridge too far.. for most – pun intended.

    Interesting chart – and interesting that Greece is number 1 :


    1. Annual mean wage of what?

  2. geo8rge Avatar

    “In 2017, the average debt was ”

    Did they mention how that was determined? One would suppose the debt of a first year student would be 1/4 of 4th yr student. Does the amount include undergraduate debt?

    I also wonder if the number means much. Many dental students are likely the children of wealthy parents who do not need to take on much debt because of parental support. I wonder what the distribution is and in particular the largest debt amounts as most of those probably (but not certainly) belong to students who have little or no financial support.

    When I searched on “why are there so many greek dentists” I found links to the 07 study and discussion.

    I don’t have time to find links but I vaguely remember dental hygienists in Japan are permitted to clean teeth independent of a dentist and dental assistants in Alaska can fill certain small cavities.

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