You may not know it, but there's a battle being waged for your teeth.
In Southern California and across the country, dentists are sending out small gifts, writing personal thank-you notes, publishing newsletters and updating their skills and their office decor as the struggle over the nation's teeth and gums becomes, well, a genteel tooth-and-nail battle for market share.
In fact, marketing seems to be the magic word in dentistry these days, one enhanced by the projection that the oversupply of dentists will continue until the year 2000.
Admissions to dental schools are being scaled back, dentists already in practice are subletting office space to newer members of the profession who are having a tough time getting practices started, some dentists are offering cut-rate pricing on certain services as "loss leaders" to attract patients and, overall, dentists are adopting the tactics and strategies of small business in a profession that has suddenly become competitive.
This academic year, for example, the first-year class at the UCLA School of Dentistry numbered 88, down from 108 five years ago. Nationally, the number of students in dental schools declined from 22,842 in 1980-81 to 20,588 in 1984-85, the latest year for which figures are available from the Chicago-based American Dental Assn. Currently there are about 127,000 dentists in this country--including 18,000 in California--up from 110,000 in 1976, the association says. Furthermore, two of the nation's 60 dental schools--at Emory and Oral Roberts universities--are being phased out, although in the case of Oral Roberts, the school's demise is not directly related to the dental climate. Applications to dental schools also are reported to be declining as students, aware of the profession's straits, choose other fields of study.
Partly as a result of this oversupply, the profession has launched a number of programs to attract attention to itself and to promote a greater degree of awareness about oral health. February is National Children's Dental Health Month, for instance, and local dental associations will be campaigning throughout the month at schools, shopping malls and elsewhere on the virtues of better dental hygiene.
In California, Wednesday is the sixth annual "Sugarless Wednesday," a day the state dental association urges the public to abstain from sugar and to read labels to find the "hidden sugar" in their favorite foods, said association spokeswoman Marci Johnson.
Moreover, national and state dental groups have in the last few years set up marketing divisions to assist their members.
Ironically, the dental profession is scaling back despite the fact that a vast, untapped pool of patients exists. At least half, and possibly more, of the population does not see a dentist on an annual basis, the national association says.
There are many reasons for this state of affairs, said association spokesman Richard Asa, including patient income, patient anxiety and public health and education programs such as the fluoridation of water that have greatly improved dental health.
But that half of the country that doesn't see a dentist regularly also apparently contains an intractable number of people who simply won't go near a drill. The American Dental Assn. estimates that 12 million people are "dentalphobics," whose fear of dentistry is so great they won't see a dentist, while another 35 million persons have "moderate anxiety," exhibited by such behavior as making and then canceling dental appointments.
There are those, however, who believe that the dental profession is suffering from its own case of unfounded, or at least exaggerated, fears.
Dr. James R. Hooley, dean of the UCLA school, for one, notes that dentists have a way of shifting ground to stay in business even though they should have been "wiped out" as overall dental health has improved. Pediatric dentists were among those once thought to be on the road to extinction, largely because fluoridation of water supplies dramatically reduced tooth decay in children, he said. But by changing the thrust of their practices to prevention, they have remained a viable specialty, he said.
"What they've (pediatric dentists) sold is a concept of prevention. . . . They will monitor your child's dental health and they will take aggressive steps to make sure that you remain in a state of health instead of a state of disease which they're controlling," Hooley explained.
Tough Going at First
He acknowledged that newly graduated dentists--burdened with educational debts averaging $28,000 and start-up costs as high as $120,000 or more--may find the going tough at first, but the frustrations are usually short-term. He also acknowledged that fewer and fewer new dentists can afford to set up shop on their own and are making arrangements with dentists already in practice to rent space in their offices.