Economic sanctions against Russia a sore point for dentists

When it comes to dentistry, the shoe is on the other foot these days. Dentists are the ones who are suffering.

Concerns over supplies of palladium, a rare earth metal used to make dental crowns, have spurred a wave of economic penalties on Russia for its invasion of Ukraine last month, leading prices to rise.

Dentists are now spending significantly more for palladium than they used to, according to Toshiaki Tanaka, the head of Hirakawa Dental Clinic in Tokyo's adjacent Kanagawa Prefecture and a director of the prefectural association of doctors and dentists.

When consumers seek treatment covered by national health insurance, a gold, silver, and palladium alloy is the traditional choice for dentists to create a dental crown due to the alloy's strength and longevity.

Another alloy that does not use palladium can be used to make dental crowns, but it is not as robust and discolours over time.

Fears of supply chain disruptions as a result of the sanctions have pushed the price of palladium-containing alloys to all-time highs.

Palladium production in Russia accounts for roughly 40% of global output. The two countries, along with South Africa, produce the majority of the world's palladium.

In mid-December, the alloy was purchased for 77,770 yen ($653) per 30 grammes, including tax.

The price reached 95,700 yen at the end of January.

The price jumped to 100,760 yen on February 25, the day after Russia's invasion kicked into high gear. The same 30 grammes may be bought for 125,400 yen as of March 9.

Because medical prices are fixed, medical institutions do not receive higher reimbursement for medical costs equal to an increase in materials when they provide treatment covered by the national health programme.

Technical competence and material fees are covered by medical fees reimbursed to medical institutions.

The material cost for the palladium alloy is currently fixed at 88,530 yen per 30 grammes, despite the fact that the most recent purchase price is 30,000 yen higher.

Palladium's price has fluctuated in the past due to its application in complex electrical auto components.

Due to the severe price changes, the health ministry plans to reassess the material's pricing on a quarterly basis beginning in April.

When the ministry examines prices in July, it is widely expected to hike material fees for the alloy to reflect the increase caused by the war in Ukraine. However, for the April review, the pricing is projected to remain unchanged.

Tanaka pointed out that if the reimbursement of medical costs to clinics is increased, as is expected in July to reflect the cost increase, patients will pay more for a dental crown.

Tanaka expressed concern that, despite having a hurting tooth in serious need of care, some patients may put off coming to the dentist for budgetary reasons.

He urged the government to take immediate action to address the problem, and he offered a measure similar to the government subsidy already in place to control gasoline costs.

"I sincerely hope that the government would address the issue of dental alloy as part of its efforts to strengthen the social infrastructure," he said.