Saturday, January 26, 2008

The sad state of dental coverage

I've long felt that America needs a universal health insurance program. Twenty years of dealing with the medical system as part of my wife's health crises has only convinced me of this further. Yet one aspect of health care that seldom comes up in these discussions is dental insurance. Katrina vanden Heuvel writes about the dismal dental care options many Americans face in a recent Alternet article.

Currently, Medicaid only covers pulling teeth to treat infections -- not root canals or dentures -- which can certainly dim the job prospects for someone trying to earn a living in our economy.

"Try finding work when you're in your 30s or 40s and you're missing front teeth," Jane Stephenson, founder of the New Opportunity School in Berea, Kentucky told the
(New York) Times.

According to Maryland Senator Ben Cardin's staff, dental decay is now the most common chronic childhood disease in the US, affecting twenty percent of children aged 2 to 4, fifty percent of those aged 6 to 8, and nearly sixty percent of fifteen year olds. It is five times more common than asthma among school age children, and nearly 40 percent of African-American children have untreated tooth decay in their adult teeth. Improper hygiene can increase a child's adult risk of having low birth-weight babies, developing heart disease, or suffering a stroke. Eighty percent of all dental problems are found in just 25 percent of children, primarily those from lower-income families.

Children of lower-income families, already facing poorer educational and work opportunities, have a further handicap when looking for work. Having to deal with potential employers is tough enough for them without worrying about bad breath and missing teeth.

This comment on the article struck me:

I am a U.S. Army dentist, and I am shocked by the dental health of the new recruits who come to my office.

I am in charge of the initial dental processing of new recruits, and the dental conditions of these kids is truly appalling. I haven't seen dental health as bad as this since my stint as a dentist in the Peace Corps. As bad as anything I saw in the third world. It's a dentist's nightmare: impacted wisdom teeth, advanced pyorrhea, untreated abcesses.. you name it.

Most of them are from the trailer parks and innercities. They are clearly embarassed by their dental conditions. For most of them, I am the first real dental care they have had in their lives. They tell some sad stories: about not having the money to afford a dentist. About pulling teeth with pliers and treating toothache with salt water. One young man told me he shoplifted penicillin from the vet supply store in his town to treat a tooth infection.

Many of these young men (and women) are well on their way to being toothless by the age of 30.

Even if you have dental insurance, it often doesn't cover much. My dental plan carries a $75 deductible for each of us per year, covers 80% on basic benefits like tooth pulling, and 50% on major benefits such as bridges and dentures. There is a $1000 limit on coverage per person per year, which you can go through in a hurry, as plates and dentures can run to several thousand dollars. My dentist's office assures me that I have one of the best plans available in the area.

Infections from dental decay can lead to a whole slew of major health problems. America needs a health care insurance system that benefits all Americans, not just those who have the money to afford it or those fortunate to have good benefits at work. Comprehensive dental care is a key element of health that too often gets overlooked.