Scott D. Beallis, DDS Ltd

12/03/2025

And here I am sharing something else by Dr. Farran. If you read this, note the important words: "For Profit." As long as someone NOT involved in a patient's care is profiting from it, the system will remain broken.

Take a look at the skyline of Chicago and count the number of buildings named after insurance companies. Then try it with physicians and/or dentists. I doubt the results will surprise you! ;-)

America’s healthcare system makes no sense because nothing else works like it. You can get a plumber at midnight or buy an 85 inch TV for cheap. You can get LASIK for less than new tires. But you wait six hours in the ER and get a five-figure bill. A dialysis machine costs as much as a car. Surgery feels like a mortgage. Plumbing, TVs, and LASIK operate in real markets. ERs and hospitals do not.

ERs must treat everyone under EMTALA, with unlimited demand and limited resources. They cannot ask about payment first. They drown in coding, documentation, and liability. The result: long waits, high cost, inconsistent access.

Dialysis is almost entirely dictated by Medicare. One federal price-setter means no real competition. Hospitals respond by cutting time per patient and hiring administrators.

For-profit insurers thrive in this maze. Premiums rise, Medicare Advantage grows, and prior auth battles keep the system complicated.

Other countries show a simpler model. Australia, the Netherlands, Japan, Switzerland, South Korea, Spain, and the Nordics deliver longer, healthier lives at half the price. They guarantee access, build around primary care, negotiate prices, and keep bureaucracy low.

The fix is straightforward. Separate insurance from routine care. Use insurance only for catastrophes. Make primary care, labs, imaging, and mental health transparent and direct-pay. Break hospital monopolies. Shrink admin waste. Invest in prevention.

Milton Friedman said if groceries worked like healthcare, your employer would pay at checkout, stores would triple prices, claims departments would deny tomatoes, and costs would rise forever.

That is American healthcare. Routine care paid with someone else’s money. No prices. No shopping. A system that burns dollars instead of delivering value.

Full story at Dentaltown:
https://www.dentaltown.com/messageboard/thread.aspx?s=2&f=263&t=394120

12/03/2025

Yesterday I linked to a post by a dentist I find to have a lot of common sense. But after I reread Dr. Howard Farran's comments, I wasn't sure that the message I wanted my patients to take from it came through clearly. So rather than leave it, I deleted it and will post the pertinent quotes instead.

"Dental insurance was never real insurance. It began in the 1950s as a prepaid children’s plan. The one thousand dollar annual max was created when a crown cost under one hundred dollars. Adjusted for inflation, that max should be about ten thousand dollars today. Dentistry advanced and costs rose, but the benefit stayed stuck in the past. What once covered a year of care now barely covers one procedure."

This bears re-reading, because I took over for a dentist who was there when dental benefits plans started to become widespread. In 1973, a lot of benefits capped at one thousand dollars. Some are still the same today. Some have gone up to twelve hundred or even fifteen hundred dollars. A few union plans (and the State of Illinois plan) go up to two thousand or more. But when you think about it, just adjusting for inflation should increase them to ten thousand or more. What could literally get you ten to twenty crowns in 1973 will now get you one, plus your routine maintenance appointments.

"People assume two cleanings a year is biology instead of bookkeeping. When insurance denies something, they think it must not be necessary."

I believe that the two visits per year came from a Pepsodent (remember that?) commercial as a way to sell more toothpaste. There is nothing scientific about it. If we prescribe cleanings every 3 or 4 months, it's because that patient will benefit from it. One study done by Dr. Rella Christensen (mentioned as an afterthought in Dr. Gordon Christensen's Update course a few years back) showed that if patients had their teeth professionally POLISHED (not scaled, just polished) every day, they would get no periodontal disease. And as we know today, Periodontal disease is linked to so much more than the health of the teeth and gums.

"Diagnosis should come from biology, not a policy written in 1964. Insurance is a coupon, not a treatment plan. Shame has to disappear. A simple “Everyone’s mouth is different” can erase years of embarrassment. People [should] understand that [true, actual] insurance pays for disasters, not routine maintenance. Dentistry is the same. Preventive care protects them from bigger problems. Doing nothing is the expensive choice, and the edentulous statistics prove it."

The fact is that dental insurance is not really insurance. It's a benefits plan, an assistance plan. Kind of like Aflac. I added the "should" and "True, actual" into Dr. Farran's quote. Understanding that it is just there to cover one thousand dollars of your dental care and has nothing to do with your dental needs is important. They don't always pay for treatments that we recommend. They use whatever loopholes they can find to deny payment. That doesn't mean that it isn't good. If you don't feel like you understand why we're recommending something, just ask! As most of you know, I love to talk!!! :-)

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09/08/2025

Dear Patients,

I am posting a copy of my recent update email to inform our patients that I will not be available for most of the month of September. I am having surgery on my left hand and will be unable to practice dentistry for about four weeks.

Dr. Syed will continue to be working throughout this time period, and Dr. Foroohar will be in the office as usual. I hope to be back to work sooner if possible.

I look forward to getting back to work in October. If you have concerns or questions, please reach out to the office, via phone or email.

Thank you for your understanding during this time.

Scott D Beallis, DDS

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09/14/2024

This second post (same series) shows that the radiograph tells a different story. Note the darkness around the roots? That indicated a SEVERE loss of bone.

This is due to trauma from a tongue piercing. The photos are swiped from an article I read in one of my journals, and without referring back to the article, I would imagine that the patient noticed that his or her front teeth were getting looser and looser. Honestly, they're about to fall out on their own!

The other photo shows how normal the teeth looked but the top one shows the periodontal probe dropping in significantly, which only the hygienist or dentist will notice.

Just a FYI

09/14/2024

I thought this was interesting. I'm going to post two photos. The patient had a tongue piercing. The damage it did was not obvious to the untrained eye by just looking. The radiographs tell a different story. See the next post (with this photo and the s-rays) for that story.

07/25/2024

The PPO question comes up often. Is there a benefit to YOU to go to an office that "takes your insurance?" What it boils down to is in-network versus out-of-network dental providers. It seems like you as a patient should pay less going to an "in-network" PPO provider when your plan suggests that you do so.

Why do they suggest this? Because they've gotten this office to sign a contract accepting lower fees than what would be usual and customary for the area. So who benefits?

Obviously, the insurance company benefits since there is less cost per procedure performed. The dentist may or may not benefit because they get new patients to come to their office. But do you benefit?

We've seen the following situations:
1. A patient who goes in-network may not have the same deductible. It may be waived or cut in half. Not always, but this is sometimes the case.
2. The insurance company may pay a different percentage of the cost. For example, they may pay 80% to an in-network office (of the fee, which is already probably discounted by 30%) and only 60% to the out-of-network provider, of the full usual and customary fee as THE INSURANCE COMPANY sets it. (Yeah, they're the ones setting those fees, usually based on zip codes and then based on percentiles. Like, 50th percentile means that half of the dentists charge more and half less.)
3. Some procedures may be covered that they won't cover for an out-of-network office. For example, they may cover a crown immediately, or after a 60 day waiting period for an in-network dentist but only after a year, or not at all, for the out-of-network dentist.

So is it worth it for you to switch? I personally don't believe it is, based on our experiences. I won't post specifics here, but suffice it to say that for the most common patient, one who needs a cleaning and exam and some x-rays a couple times a year, there is generally NO DIFFERENCE in what you pay, at least at my practice. You can't get more than 100%, and most Blue Cross, Aetna, Cigna, Metlife, and others pay us our full fees for those recall appointments. It will not necessarily save you any money to go to an in-network provider.

What do you get from us that you can't be certain you will get from a participating provider? I've spent 38 years building TRUST with my patients. As my guiding principle, I look at every case with an eye on what is best for my patient and what fits their specific needs best. I have never let money guide my treatment recommendations, unless to meet a patient's stated objectives.

Remember this when choosing your dental provider, be it me, or one of the other excellent practices in our area.

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04/18/2024

I saw my old mentor Dr. DeWitt Wilkerson speak a couple Fridays ago about dentistry's role in a person's health, then I bought and read his book, which was eye opening in a lot of ways. Specifically, Dr. Wilkerson discussed the role of inflammation in so many disease processes in our bodies, and how we might see evidence of some of these in the oral cavity, which is, after all, the "entrance" to the body. Airway and breathing were only one of the ways our overall well being is affected. We can also tell a lot about the body by what we see in the gums and on the teeth, especially in the wear patterns we might see.

Dr. Wilkerson discussed clenching as the body's strategy to help open the airway by elevating the hyoid bone and increasing space for breathing. He discussed mouth breathing vs. nasal breathing, and anti-inflammatory diets and the role of the TM joint in some of this also. It all made so much sense.

This book is available on Amazon, and does a good job of explaining a lot of things. Maybe it's all true, maybe it's not (in that maybe things DON'T work this way) but all of it has good solid research behind it, and if you're concerned about your own health, it might be worth looking at. I'm happy to discuss this at your examination appointments more, also.

04/03/2024

Everyone
Today's Topic: Antibiotic Prophylaxis for Joints

(sorry in advance for using the at everyone tag but I think this is important)

I said I would post on this topic a while ago, then dragged my feet. Besides the Gordon Christensen update course we attended last fall, I had the chance to see my old classmate, Dr. Thomas Borris, at the Chicago Dental Society's midwinter meeeting, where he gave a talk called "Was Darwin Right?"

What my friend was talking about was bacteria. How do they "evolve?" And how does their evolution affect us humans? Well, that's easy. It's by causing diseases. And how do we fight them? With antibiotics, generally.

But guess what? They're evolving. Adapting. There are now tons of antibiotic resistant strains of disease causing bacteria and other germs.

One of the most common ways we use antibiotics is to prevent infection following joint replacement. But should we? As usual, the answer isn't simple. Let's start by stating that there is NO evidence supporting an association between dental procedures and the risk of experiencing "periprosthetic joint infections." If we take the idea of bacterial invasion via dental procedures to its absurd conclusion, then one should not even brush one's teeth because it is certain that bacteria are introduced into the blood stream after brushing, especially in patients with gingivitis, which is pretty much everyone.

New guidelines from the American Academy of Orthopedic Surgeons state that we should not use antibiotics after (to be safe) 6 months post-surgery. (Actually, the AAOS says no dental work within a "few weeks" but we are saying it should be at least 3 months hand maybe 6 months for hygiene visits and needed restorative work.) Late infections are very, very rare.

It isn't my place as a dentist to make this determination for you, however. We should and will defer to your orthopedic surgeon or to you yourself on the final decision. It is suggested that we do not write the prescriptions, however. The orthopedic surgeon should write them IF THEY REQUIRE THEIR PATIENTS TO TAKE THEM FOREVER.

One other point: For penicillin-allergic patients, Clindamycin is NO LONGER the drug of choice in joint prophylaxis. The risks of C. Diff colitis is MUCH HIGHER than the risk of joint infection. Instead, Z-pack (azithromycin) is recommended for use.

Want to look for yourself? I'm going to put a l1nk in the comments so that you can check on the "Appropriate Use Criteria" on the AAOS slte. When you follow it, go to "Appropriate Use Criteria" then scroll down to "Management of Patients with Orthopedic Implants Undergoing Dental Procedures" and go to the "Indication Profile" and answer the five questions there for yourself. Then click "Submit". You can see what it says for yourself.

Please, discuss with your physician or your orthopedic surgeon (if he is still practicing; I can't tell you how many folks have had joint replacements so long ago that their surgeons are either retired or have long since moved out of the area). If they want you to have the antibiotics, ask them if they will prescribe them.

We will still prescribe in some cases, but I can guarantee that younger dentists are usually NOT prescribing, instead are asking patients to have their surgeons or physicians prescribe what THEY want.

Thanks for reading this long (but important) post!

12/29/2023

Today's topic: Airway and Dentistry.

I read an article a few weeks ago that made me think about some of the issues we see often in practice, and how they might be related to, or be indicative of, airway issues. A lot of things we see on a daily basis, like wear and cracks, decalcifications, even cavities, can result from obstruction of the airway.

Mouth breathing will lead to a dry oral environment, and this can in turn lead to a decrease in the saliva's effect on plaque/bacteria. Also, developmentally, a lower tongue position due to breathing issues can lead to a narrowed palate, since the tongue doesn't provide the "scaffold" for the arch form.

Clenching and bruxism can be caused by unregulated sympathetic nervous system responses. There are a lot of things that can interfere with the normal responses, but airway issues might be the most common. Clenching/grinding/bruxism can lead to wear, recession, abfraction, cracked cusps, cracked teeth, tooth mobility, temperature hypersensitivity, and a few other things. These things can lead to root canal issues. And periodontal problems can also be related to airway problems. (A recent study showed that the highest incidence of stage 3 periodontitis (advanced) is among patients with severe obstructive sleep apnea (OSA).)

So you thought that the crowding issue was just a cosmetic issue? Think again. It could be a sign of, or a predictor of, a sleep apnea/airway issue. That's one of the reasons that, if we see crowding, we look for a narrow arch form, and suggest early orthodontic intervention.

I have another one that I'm trying to work up concerning taking those antibiotics if you've had joint replacements.

12/06/2023

11/21/2023

A very Happy Thanksgiving to all our patients and friends! From Dr. Beallis, Dr. Foroohar, and our great staff!