In 1987, when my husband and I were graduating from dental school, they told us that by 2012, 25 percent of dentists would have nothing to do. Strange as that sounds now, we were in dental school at the precise moment in time when the result of municipal water fluoridation was becoming very clear: Fluoridating water was reliably reducing tooth decay by as much as 60 percent. We easily calculated that we would be only 52 years old and probably running out of work.
No one in 1988 could have imagined that by the year 2000, 75 percent of middle schools and 98 percent of high schools would be selling intensely sugared drinks in vending machines.
No one could have imagined that between 1977 and 1996, the average size of a sweetened drink would increase by almost 33 percent, and Vermonters would consume, on average, 50 gallons of sugar-sweetened beverages a year.
Who could have guessed that in the year 2010, the American Heart Association would report that children ages 2 to 18 would be getting 35 percent of their daily calorie intake from soda/energy/sports drinks.
Of course, you all know the rest of the story: Dentists are not out of work, and there is said to be an access to care problem.
If the previous statistics don’t surprise you, this might: My husband and I estimate that approximately half of the dentistry we do for people under the age of 40 is completely due to diet choices — largely sugar-sweetened beverages. Children or adults, rich or poor — when we ask folks what is their daily “drink of choice,” plain water and milk are almost never on the list anymore. So we ask you: If dental need was cut by 25 percent, would there still be an access to care problem?
Our experience tells us that this is actually an excess of need problem. These sugar-sweetened beverages just don’t hurt people’s teeth for a month or a year. They permanently change the hardness of the enamel, and they leave people with teeth that will require high maintenance for the rest of their lives.
Even as we write, Vermont is staffing more and more state-funded dental clinics. None of them break even. All of these clinics must require huge cash infusions to balance their budgets at the end of the year, and nothing on the horizon promises to shrink that taxpayer-funded chasm, except changing consumption.
So our question to you is this: Where in this equation can we make the biggest impact to decrease demand for dental services? Of course we all know the answer: at the source. And that would be to discourage the consumption of sugar-sweetened beverages. All economic models — from the dawn of time — show that increasing costs will decrease demand. It’s as simple as that.
And where a penny-per-ounce tax does not discourage consumption, at least the state will have gained revenue to pay for the demand for dental services if it continues to increase. And that money would come from the proper source — people who drink excess sugar-sweetened beverages. Remember that statistic about the average Vermonter drinking 50 gallons of sugar-sweetened beverages a year? If you don’t drink that much, that means someone else is drinking your share or way more.
Every day we drop our daughter off at high school and see dozens of teens carrying 20-ounce soda bottles into school at breakfast time. We shake our heads. Sometimes the most obvious solutions are the hardest to accept. This is not that complicated if we can find the political will to stand up to the powerful beverage industry.
Dr. Lynda Ulrich practices dentistry in St. Albans.
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