COST is surely a major factor when considering dental treatment in Guyana. Why is it so expensive to have dental work done in the private sector? Is the public being exploited by private dentists? How could you know if your dentist is overcharging you? Is it possible for comprehensive dental care to be within the reach of the low-income citizen? Undoubtedly, these are burning questions and an attempt would be made to answer them.
Anyone who has made a deliberate effort to systematically study and compare oral care delivery from an international perspective, would know that dental treatment is exceptionally costly all over the world. Many governments realise that the poor masses would not be able to pay for treatment. In fact, when research done by the renown universities confirmed the enormity of the social and economic impact on most countries, public health dentistry was introduced as a specialised field of study.
So, since 1939 the strategy was to emphasise on prevention with water fluoridation on the forefront. But even a national prevention programme whose aim is to cut down cost, itself proved to be too expensive for some governments. And in any case, it takes many years before a national prevention programme manifests itself sufficiently to be obvious.
This fact alone often serves as a disincentive for economies to spend scarce money on something not generally considered to be a matter of life and death. In addition, politicians and technocrats, quite understandably so, could never be convinced that the oral health status of the population is just as important as the numerous ‘priority services’. I can personally attest to this fact as I once worked as the link between the dental health service of the Ministry of Public Health and the political directorate.
Private practice has flourished mainly against the backdrop of governments’ inability to adequately provide dental services for the population. As a result, numerous quacks and charlatans openly exploit the population and governments turn a blind eye to this unfortunate situation, simply because the suffering public often has no other place to turn to for help. Furthermore, despite the fact that dentistry is certainly the most expensive career to pursue, many private dentists have capitalised on, and exploited the circumstances.
The criteria used for charging fees greatly depend on the dentist himself or herself. Naturally, the primary expense the patient pays is the so-called overheads, which include rent, material, electricity, staff salaries and income tax, etc. After the dentist has added his/her personal earnings, the average cost of an extraction should be $4,500 and a filling $8500. Prophylaxis should be in the vicinity of $6500.
Clearly, patients who prefer an air-conditioned, carpeted office with Mozette paintings on the walls, where coffee is served while you wait, must expect to pay dearly for such luxuries. Some dentists are encouraged and ‘spoilt’ by patients who unflinchingly pay obviously unreasonable fees for simple conventional procedures.
And in some cases, patients pay more for simply who they are, especially business persons. Some people erroneously evaluate the quality and standard by how much they pay. So, they assume that a dentist who charges high fees is better than one who charges low fees. Incidentally, patients who sometimes contemplate the question of quality of work must be aware that this has far more relation to impropriety and negligence rather than the doctor’s incompetence.
The first step in ensuring that you are not exploited by your dentist is to know what the prices various others charge are. Dentists who are reluctant to disclose an average cost of their fees could be considered less than honest because they cannot inflate their charges in a whimsical fashion. Try to find out and pay for a procedure before it is done.
If the dentist asks you to pay afterwards you feel psychologically insecure and may become exposed to exploitation.
In addition, asking you to pay after the procedure instead of before, could be a trick to force you into commitment with a cost for which you cannot escape. Wherever possible, always seek a second opinion. One can consult with any or even all of the dentists at the Cheddi Jagan Dental Centre for a very small fee.
Guyanese who fall in the low-income bracket can have adequate dental coverage by means of dental schemes similar to that existing in other countries. Workers contribute a small monthly fee monthly or weekly to a fund which pays a group of private dentists to provide dental treatment for them. This system differs somewhat from our own NIS in that it is voluntary, the patient never pays the dentist directly, all the dentists involved charge the same fee and every dental procedure is accessible to the patient.
Apart from this, the participating dentists are monitored and required to meet established ethical standards.
Private enterprises are especially attracted to these schemes because the owners profit in one way or another. Insurance companies also become involved with dental schemes which can make a handsome profit while simultaneously benefiting their contributors.
