Dental care will be denied for a large part of the American population when the Affordable Care Act takes effect January 1, because it doesn't provide dentistry services for adults.
The national Affordable Care Act, which is intended to provide health care coverage to millions who haven't been able to afford insurance or don't otherwise have access to it, doesn't provide dental insurance coverage for adults.
In an era when people are living longer, that not only means that the state of their oral health is at risk, but that it could lead to other medical issues associated with bacteria from decayed teeth and gums.
"Until we have an expansion of this kind of coverage, and until we have people really recognizing what this means for their overall health, I do believe we have an unimaginable tragedy on our hands," Beth Truett, president and CEO of Oral Health America, told CNN.
Older Americans may be at the greatest disadvantage. A report by OHA stated that as few as 2 percent of senior citizens have dental insurance, in part because Medicare doesn't cover dental work. Medigap insurance, so called because it's supposed to fill the gap between Medicare and private coverage, also doesn't typically include dental health.
One alternative that can help people without insurance is an individual or family dental plan that covers many dentistry services at reduced prices. By signing up for a discount dental plan, more people may be able to afford the out-of-pocket expenses of these lower-priced services.
Aging population at greatest risk
With the aging of the large baby boom population, the possibility of more health issues stemming from dental problems is looming without respite from the national health program that's supposed to provide greater access to medical services.
"People in the United States are retaining their teeth, and as a result, teeth that have been in use for 50 or 60 or 70 years will have problems," Ira Lamster, dean emeritus of the Columbia University College of Dental Medicine, told CNN. "For instance, if you have diabetes and you have gum disease, your metabolic control will be worse. There is a lot of data showing that periodontal disease can increase your risk for heart attacks and strokes. There are so many ways this can impact your overall health."
Because of the high cost of private dental insurance, many adults can't afford some of the dentistry advances, such as dental implants, that could help people who may be at risk of losing teeth because of serious tooth decay and gum disease.
Some options for dental care
Although low-income adults are the most likely to go without dental coverage, only 29 states provide dental benefits or emergency dental provisions under adult Medicaid plans. Still, for those in most states that don't offer this provision or don't qualify for the benefit, the alternative very often is a visit to a hospital emergency room.
OHA found that emergency room visits for dental health reasons have doubled in the past decade. Its data showed that from 1999 to 2000, there were about 1 million such cases involving adults over age 65, compared to 2.3 million cases from 2009 to 2010.
However, the number of federally qualified health centers that now offer dental care has gone up, and in most states, a state-sponsored oral health plan is available to some adults.
In addition, OHA's website, toothwisdom.org, has a guide that helps the public find dental care in their state and includes transportation options for older Americans who may be too old to drive, or people who may live at a distance from dental services.
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