When we think about the general health in America, and the successes and shortcomings of the Patient Protection and Affordable Care Act (PPACA), we can notice that dental care is given little attention. Although PPACA does provide dental coverage for those under 18, it doesn’t for adults. The nation’s largest insurer, Medicare, doesn’t cover routine dental work. The Medicaid coverage for adults is different in every state.
According to statistics, about 108 million U.S. citizens don’t have dental insurance, and 1 in 4 nonelderly deal with untreated tooth decay.
Nice teeth are not the only thing to consider in oral health. Oral health has been closely related to overall health and can be involved in or aggravate heart disease, diabetes, stroke, and pregnancy complications, according to a 2000 study.
The lack of appropriate dental care has caused a lot of suffering in millions of Americans, in terms of pain, poor health, and the social opprobrium related to bad teeth.
Dental care is Desperately Needed by People
There was a national study conducted in 2003 and 2004, which involved uninsured Americans in northern Idaho, southcentral Illinois, the Rio Grande Valley of Texas, the Mississippi delta, and in eastern Massachusetts. The 150 interviewers were asked if the current president (George Bush) announces universal health care for all, what will be the first health problem they will take care of. The majority answered that they will immediately go to the dentist’s office.
Although a great number of the interviewed people dealt with untreated asthma, diabetes, and even cancer, they still thought their oral health issues were the biggest challenges to their life quality.
It was recently when these communities were again interviewed on the same topic, and their answer was practically the same, even after a decade. Although many of them now had some sort of health coverage (almost 20%, resulting in becoming disabled sufficiently enough to get Social Security), the number of those who succeeded to secure dental coverage is extremely low.
Many people stated that in order to reduce the pain, they visited emergency rooms or used addictive pain medications. Some of them have even pulled out their own teeth.
One of them is Misty, a mother of five. In 2004 she told the interviewee that despite her problems with headaches, domestic violence, and diabetes, she was in fact most troubled by her bad teeth. She has even pulled out her teeth when she couldn’t handle the toothache.
By 2016, she managed to leave her husband, move to Arkansas, and be accepted onto disability, thanks to which she got Medicaid health coverage. Regardless, Misty was still suffering from the bad condition of her teeth.
Somehow she managed to find a dentist who accepted her health care provider, Medicaid, and she got the rest of 25 teeth removed in one day.
Unfortunately, Misty’s story is not uncommon. There were a lot of men and women of different ages who had to pull their own teeth because of a lack of dental health coverage. There were some who got some dental care during the short periods of Medicaid dental health coverage, but after it ended, their treatments were left unfinished.
Insurance Stops at the Teeth
Insurance plans continue to ignore the fact that our overall health is closely connected to our dental health.
When health insurance started in the U.S in the 1920s, and then during WW2 and afterward, dental care wasn’t included in the regular package of the covered services.
Medicare has an important role in setting the norms of health care coverage, as it’s the largest insurer in the U.S. Nevertheless, it doesn’t offer dental care. In fact, about 70% of seniors don’t have dental health coverage, according to government statistics.
The senior program officer at the Robert Wood Johnson Foundation, Dr. David Kroll, argues that as Medicare doesn’t offer dental coverage, this unchanging condition influenced ACA (Affordable Care Act).
Dental plans aren’t cheap at all, and they require further payments for procedures other than preventive care, and very little or no coverage for bridges, dentures, or periodontics work.
Moreover, recently the dental care costs have elevated faster than that of other types of medical care. There are just a couple of cheap dental services available for those without dental coverage.
Although the Affordable Care Act provided enlargement of the eligibility of Medicaid, not all states accepted federal funding. Even in those states where Medicaid expanded, the low and moderate-income Americans were left with the same strict limits on oral dentistry.
However, one good thing is that all Affordable Care Act compliant acts and Medicaid too, include the required benefit of dental coverage for children. The American Dental Association and the Health Policy have calculated that the percent of children with Medicaid insurance who utilized dental care PNHP from 35.5% in 2005, to 48.3 % in 2013.
Oral Health is Way More Than Just Nice Teeth
A lot of Americans suffer from the lack of coherent oral health services, and many of them resemble the story of Gina. She is a young woman from Idaho who can’t be hired as a telemarketer and can’t speak if she doesn’t hold her hand over her mouth because of her rotted teeth.
Although many people think that bad or rotten teeth are a result of bad decisions, the reality is that 2 dental checkups a year, which are available for those with dental health coverage, can maintain the healthy teeth and notice potential problems which can be treated in time.
The sad truth is that tooth decay represents poverty. If oral health insurance doesn’t expand, millions of U.S. citizens will continue to live with the pain, shame, and risk of systematic diseases which can be prevented by an integrated and accessible system of dental health care.