Even when a patient seeks care from a licensed dentist, their oral health is often too far gone for simple preventative dentistry to deal with. Greenwalt said that her clinics she's seeing an increasing number of patients -- some of them children as young as three -- who have so many rotten teeth that she admits them to the hospital and operates under general anesthesia in order to treat them. Once again, the taxpayer often picks up the bill.
A more sensible, less costly approach, said Catalanotto, would be to "increase oral literacy" by better educating consumers on the basics of oral hygiene. That way they could take more responsibility for their dental health.
He also said there is pressing need for expanded access to high-quality low-cost services -- an idea that's backed up by statistics.
For example, the non-profit advocacy group Oral Health America says there should be one dentist for every 1,500 people. Currently there is one dentist per 2,000 Americans -- and they are unevenly clustered geographically. Oral Health America highlights one urban area in Washington state that has one dentist for every 950 people, while a neighboring rural county had one dentist per 12,300 people. And Pew reports that more than 28 million Americans have no reasonable expectation of finding a dentist in their community.
Catalanotto said that in order to avoid more tragedies like the Miami case, dentists will have to advocate that some of their work go to dental hygienists and other mid-level providers (analogous to physician's assistants) to deliver services to under-served and low-income communities. In most states, this is currently against the law.
Another solution may be to bring at least some of the illegal underground dental network into the fold. One of Catalanotto's University of Florida programs prepares foreign dentists to pass licensing exams so they can practice legally -- and safely.