Slusarewicz ’23: We need to start caring about dental care


When I was young, I didn’t know he was banal. Due to the economic recessions of the 2000s, my family’s income was fragile for many years, and even after the Great Recession, we moved many times for work. Most of the time we didn’t have the stability to attend regular medical appointments due to our high health insurance deductible – under which there are usually large out-of-pocket payments – not to mention going to the dentist, which was not covered by our insurance. When I started attending regular dental appointments in college, I was blown away by the experience. But we still don’t have dental insurance and pay for appointments without help. So, if our financial situation were to turn grim again, we would once again give up on dating.

General medical opinion regards oral health as an essential element of public health. Poor oral health correlates with deterioration of physical health and quality of life and disproportionately disadvantages marginalized communities. Yet the sluggishness of dental care covered by public and private health insurance perpetuates the Perception that dental care and non-dental care are inherently separable. Dental care is unaffordable for many Americans and insurance plans often fail to cover important transactions. Comprehensive dental care must be fully covered by public and private health insurance policies if we hope to promote the health of all Americans.

Poor oral health can contribute to many illnesses and ailments, including cardiovascular disease, pneumonia, and complications of pregnancy and childbirth. And the relationship between oral and non-oral body health works both ways. For example, diabetes and gum disease to get worse each other in a positive feedback loop, and terms such as HIV/AIDS, osteoporosis and Alzheimer’s disease lead to dental decline. Despite the potentially serious effects of neglecting oral health, lack of access to primary dental care discouraged people to use the medical system until an emergency occurs, with both medical and financial consequences.

Financial obstacles add to these disincentives. Dental expenses represent less than 4.5% However, health care expenses constitute a large part of patient expenditure: a staggering 44.2% of dental bills were paid out of pocket, compared to 10.3% of medical expenses, which are largely covered by plans. insurance. Recent search noted that the expensive nature of dental care prevents medical insureds from meeting their treatment needs.

While the federal Medical help helps alleviate some of the economic burden of oral health care for low-income individuals and families, it remains insufficient. Although Medicaid is supposed to cover dental care for all children, less of more than half of eligible children actually receive dental care. Also, adult dental care depends on state Medicaid policy. In 2016, 15 States provided extended dental benefits for adults, but 13 provided dental coverage only for emergency care or pain relief and four states provided no dental benefits. But even if a state offers substantial dental care, individuals are limited by the ability to find dental professionals in their communities. less than half of US dentists participate in the Medicaid dental program due to low reimbursement. As a result, dentists tend to set up businesses in affluent areas where residents can afford better insurance or pay for procedures out of pocket. As a result, poorer areas of the United States offer little or no access to dental care – more than 50 million Americans live in communities with a federally designated shortage of dental professionals.

Medicare, which insures those 65 and older or disabled, also provides insufficient dental coverage. The program does not cover primary dental services — “care, treatment, extraction or replacement of teeth or structures directly supporting teeth” — necessary for the installation of dentures and the extraction of diseased teeth. Also, while it covers necessary surgery for “non-dental” procedures, Medicare will not pay for dentures or any other type of device needed to care for the mouth after surgery. Health insurance’s shortcomings in dental coverage are particularly glaring because of the heavy Burden of oral disease on older populations.

While the separation of dental and non-dental medical care in health care policy disproportionately harms marginalized communities covered by Medicaid and Medicare, a much larger group may feel the consequences. Among civilian workers who received occupational medical insurance in 2018, such as my family, only 44% received dental coverage thus, leaving the rest uninsured for dental care. The rate of uninsured dental care is four times higher than the rate of uninsured medical care, some 74 million Americans don’t have dental coverage in 2016. Even those who can purchase separate dental insurance don’t get all the coverage they need. For example, many private dental insurance plans do not cover dental procedures which can be costly. Although dental insurance companies cover preventive care, regular dental maintenance is not completely sufficient. eliminate the risk of dental emergency.

All of these factors add up to paint a clear picture of dental care in the United States: inaccessible and unacceptable. As a medical journalist Mary Otto “Due to economic deprivation, geographic isolation, age, disability and lack of dental coverage, an estimated one-third of the population faces significant difficulty in accessing the autonomous, island and privatized that provides most dental care in this country.”

Tackling disparities in dental care could, in turn, improve dental coverage for everyone. The Medicare and Medicaid Dental Act, Vision and Hearing Benefit Act, introduced in the US Senate on August 5, would greatly expand the scope of dental care covered by the Medicare and Medicaid programs. This legislation could be the first step in changing attitudes towards dental health, but for now the bill has a 3% chance of succeeding, according to predictions from machine learning prediction company Skopos Labs. For real progress to be made, dental health must be seen as inseparable from non-dental health at the level all levels. It’s time to move beyond outdated insurance structures so we can focus on improving the health of all Americans, regardless of socioeconomic status.

Megan Slusarewicz ’23 can be reached at Please send responses to this opinion to and other editorials to


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