HJLR May/Jun 2019

dialogue 16 MAY / JUN 2019 I  Healthcare Journal of LITTLE ROCK   Choate One recently developed treatment option we are proud to offer all of our mem- bers is silver diamine fluoride (SDF). SDF is a clear liquid that only requires one drop applied to the site of a cavity that arrests, or stops, decay as soon as it dries. It is a quick, low-cost, and pain-free alternative to drilling and filling for some situations and patients. It can be a great option for certain young children, elderly patients, those with special needs, people in extremely remote areas, or someone who may have trouble tolerating traditional cavity treatment procedures. For example, my mother is 85 and has advanced Alzheimer’s disease. She would not be a good candidate for traditional treatment for a cavity (local anesthesia, high-speed drill, restoration, and holding her mouth open for several minutes), which, if left untreated, could cause lot of pain. In consultation with her dentist, we might determine SDF is the perfect solution for her. SDF’s low cost makes it accessible to more patients, and the procedure is covered by most of our commercial dental plans, and for all of our Medicaid/Smiles members. Editor How would you characterize the dental market place in Arkansas? Too many, or not enough dentists? Choate Arkansas has approximately 1,200 actively practicing dentists. About 85 per- cent of them are General Practice den- tists and about 15 percent are specialists (e.g. orthodontists, oral maxillofacial sur- geons, and endodontists). Our state is often listed among those with the fewest practic- ing dentists per capita in the United States. That statement is frequently accompanied by the fact that Arkansas is one of the few states in the country without an in-state dental school. While both statements are true, the bigger issue is one of provider mal- distribution (too many concentrated in too few places). The amount of dental educa- tion debt (often $250-400k), the cost of pur- chasing or setting up a dental practice, along with the cost of living and raising a family, leads most dentists (like their medical col- leagues) to more urbanmarkets where there are more potential patients. Education debt is becoming a national problem that extends far beyond graduat- ing dentists, but it is undoubtedly impact- ing access to care because it often drives where a newly minted dentist can afford to practice. By the way, an in-state dental school doesn’t lessen the problem unless it