Why is Dental Care not Healthcare?

According to the US Centers for Disease Control and prevention, about one-quarter of Americans 65 and older have lost all of their teeth. One-third have untreated tooth decay, even though poor dental health is linked to heart problems and other health concerns seniors already face, such as diabetes. Almost 8,000 people in the United States die of oral and pharyngeal cancers every year, most of them elderly. But the problem is not limited to seniors. Children from lower-income families are twice as likely to have tooth decay

The bottom line is that although healthy teeth are essential for good overall health, they have never really been considered a part of the body by many insurers and third-party payers. Even though the links between oral health and numerous other conditions such as heart disease, pneumonia and fetal health are well known, more than 180 million Americans never visit a dentist.

The Affordable Care Act (ACA) brought health insurance coverage to millions of people who had never had it before. Not only did the sweeping changes put an end to exclusions for pre-existing conditions, but healthcare reform also designated 10 “essential benefits” that insurers must include in their plans, such as treatment for mental health problems and drug and alcohol abuse.

The idea was to provide coverage for things that could improve a person’s overall health at a relatively low cost. The theory? Keep people healthy by taking care of small problems before they become big, expensive ones.

The partition between dental and medical makes little sense given that “oral health is directly related to general health,” says Dr. Garry Glassman, an endodontist based in Toronto, Canada who also practices in the U.S. “The oral cavity is a gateway to your body. A lot of stuff in the mouth can indicate kidney disease, heart disease, diabetes, HPV, cancer, etc. Your dentist can be your first line of defense.”

Even if you do have dental insurance it is likely restricted to only certain procedures and carries an absurdly low annual payout cap - often $1,200. So why does something as basic as dental care continue to take a back seat, even with the new emphasis on preventive medicine?

The answer, apparently, is "because that is how it has always been".

Despite it being a plainly medical issue, until the 1800s, dentistry was the domain of barbershops, practiced in the same chair and usually by the same guy who shaved your beard. It’s so bizarre and frightful an image that it’s almost comical, but the history of our teeth and jaws being treated as something as incidental as our hair and nails still haunts us.

Meanwhile, millions of non-wealthy people continue to suffer the genuine agony and negative health consequences of bad teeth. Read more here.