Monthly Archives: April 2012

Maryland Bridge

Maryland Bridge #25 bonded in

One might wonder why a dental prosthesis like this is called a “maryland bridge?”  The technically correct term is an “etched bonded fixed bridge” but since it was developed at the University of Maryland, it has become known as a “maryland bridge.”

To begin with, any dental bridge replaces missing tooth/teeth.  Dental bridges are either fixed (NOT permanent) or removable.  Fixed bridges can be of traditional design (crowns on teeth adjacent to the missing tooth/teeth) or etched bonded bridges (the Maryland Bridge.)  A Maryland Bridge does not require the adjacent teeth to be miniaturized (ground down to little nubs.)  Most Maryland Bridges have a much shorter life expectancy than traditional fixed bridges, but they require far less irreversible alteration of the adjacent teeth.

In my Palm Harbor, Tampa area dentist office I have made many Maryland Bridges over the past 25 years but they are still just a tiny percentage of the overall tooth replacement process.

Dentistry is considered a specialty under the overall umbrella of medicine in some countries.  In the United States of America, dentistry has evolved as a completely different branch of health care.  This difference is evident in many ways.  In this blog I would like to discuss the economic aspect of this difference.

It is almost universally agreed that the economics of our medical delivery system is in great need of change.  How and what changes are necessary is subject to great debate.  We compare our system to other models through out the world.  We look at the Canadian and many European models as comparisons.  Opinions are divided.  Some contend that these “socialist” systems are more fair, some feel that care is inferior, some that care is harder to come by, but most do not want our system to become “socialized.”  I contend that our medical care delivery is already socialized and we all know that on a large scale socialism as an economic model does NOT work!

Socialism / Communism are ideals. Human nature runs contrary to these ideals. Nature itself runs contrary to these ideals. Pure, unchecked capitalism is like evolution, only the strongest and most fit survive. Medical advances have changed human evolution. I, for one, would not be alive today if it were not for antibiotic’s.

Many of today’s economic scholars might argue that the closest we can come to a perfect model is some government control over capitalism. The debates focus on what type and how much influence should government exert. The current medical care delivery system DOES NOT work because it already is a socialist system. The receiver of care/service does not directly pay for this care/service. One reason capitalism works is because of choice based on economics. I am willing to pay for something that I need and I am willing to pay more for something that has a greater value. In our current medical delivery system, “If my insurance pays for it, do it,” even if the treatment only has a 15% chance of success. How many of us would be willing (or able) to pay tens or hundreds of thousands of dollars for an 85% failure rate? The receiver of care should have some “skin in the game.”