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Dentistry and American Healthcare

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I’ve made this point before and no doubt will make it again. Despite my personal hatred of going to the dentist (quit torturing me!), perhaps the single stupidest part of this broken healthcare system we have in the United States is that dentistry is considered a separate category. Why do we take one part of the body and separate the health care necessary for it from the health care necessary for the rest of the body? This is utterly, completely nonsensical. And it has real life and quite significant consequences on people.

Maureen Haley, 66, lost her home in Florida in the wake of the 2008 recession. She now lives in a camper near Greensboro, North Carolina, relying on social security and Medicare to make ends meet and pay for healthcare.

But Haley has problems with her teeth, and cannot afford to see a dentist to have them fixed.

“My teeth problems are the biggest problem I have each day,” said Haley. “I need root canals and implants. I have a tooth impaction. I have to massage the heck out of it to get the air out of my gums and cheek after chewing a meal. Painful is an understatement, and the worry of how this may affect my heart compounds it.”

She worries about remaining independent, and not ending up in a nursing home. On a limited income, her decisions revolve around what is most pressing, such as fixing her vehicle and drug prescriptions. The last time she was able to visit a dentist was three years ago, and she was given an estimate of over $8,500 for the work she needs.

Haley is one of millions of Americans who have no dental insurance coverage and cannot afford to pay out of pocket for extensive dental care needs, including nearly two-thirds of Medicare beneficiaries – about 37 million people. An estimated 74 million Americans have no dental insurance coverage. A survey by CareQuest Institute for Oral Health released in April found an estimated 6 million Americans lost their dental insurance during the pandemic.

The disparities in oral health in the US are prevalent among racial and economic lines, with Black, Hispanic and lower-income Americans experiencing higher rates of tooth decay, gum disease and oral cancer, as more than half of Americans avoid or delay healthcare, including dental care, because of high costs.

The importance of oral health is directly linked to overall health. Dental problems are linked, or suspected to be linked, to cardiovascular and other serious health problems such as diabetes and Alzheimer’s.

Loxi Hopkins, 68, of Davenport, Iowa, and her husband have severe dental issues – but their Medicare package won’t cover any of it.

She is currently in need of thousands of dollars in dental repair.

This is just completely unacceptable. We aren’t going to get universal health care anytime soon. But how hard would it be for the Biden administration to prioritize changes to Medicare so that it covered mouths as it covers joints and bones and brains? I don’t actually know the answer to that question; health care is not a policy area that I follow all that closely. But what I do know is what any person with even an ounce of common sense should know: that this has to be fixed, yesterday.

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