To Ensure Healthy Communities, We Must Invest in Dental Care

Everyone should have access to high-quality, affordable dental care.

Oral health is integral to overall health, and has drastic implications on a number of other quality of life indicators. Yet unfortunately, millions of people in this country lack access to the dental care they need to lead healthy lives, largely because they can’t afford it. Indeed, even though tooth decay is virtually entirely preventable, it remains the most common chronic disease among children in the United States.

People with low income are more likely to lack access to oral healthcare.

There is wide variation in Medicaid coverage for adults between states, and no coverage benefit for Medicare. Accordingly, adults living below the poverty level visit the dentist significantly less than people who are not poor. And, although dental care for children is covered under Medicaid, in 2015, fewer than 50% of Medicaid-insured children had visited a dentist in the past year.

Disparities in access to oral healthcare disproportionately harm people of color.

Dentistry, like medicine more broadly, was shaped by and reflects our country’s history of segregation and structural racism. As a result, communities of color experience greater oral health problems and receive fewer preventive dental services than white people. And increasingly, misguided and harmful anti-immigrant policies have created a climate of fear that is discouraging families in immigrant communities from seeking out the regular, preventive dental care everyone needs.

Lack of access to oral healthcare can have devastating impacts in both the short- and long-term.

When left untreated, tooth decay can cause significant pain, require high-cost emergency care, and even result in death. Infections in the mouth are linked to a broad range of health problems, including heart disease, preterm birth and low birthweight, difficulty eating, and weight issues. Moreover, poor oral health can hinder educational attainment for children, impact job prospects for adults, and undermine seniors’ quality of life.

But no one should have to suffer worse health or die because of a toothache.

To ensure strong, healthy communities, we must improve access to oral health care. Even in face of the assault on access to healthcare being waged by the Trump Administration and congressional Republicans, state and local leaders can take action. Some opportunities include:

• Emphasize prevention to catch and address problems early, before they become costly and more difficult to treat. In Illinois, for example, the state legislature recently passed a bill that requires dental examination at the high school age; if signed into law, Illinois will have one of the strongest policies in the nation to advance oral health at a critical and unique transition point in the life course.
• Encourage a team-based, holistic approach to oral healthcare that includes community health workers and mid-level dental providers. Millions of Americans live in dental healthcare shortage areas, and only 39% of dentists in the United States provide dental care to children that are publicly insured. Expanding and diversifying the dental workforce is a promising strategy for addressing provider shortages and improving access to oral healthcare, and states that put fewer restrictions on dental hygienists see better dental health outcomes in adults.
• Increase the list of services covered by Medicaid to enable health providers to better support, educate, and engage with their patient communities, including parents and caregivers of young children and individuals with special needs.
• Advocate for the addition of a comprehensive dental benefit in Medicare. One-third of older adults have lost six or more of their teeth. As we live longer lives, it is critical to support seniors’ oral health to improve their quality of life while decreasing the cost of their healthcare.
• Protect and expand Medicaid coverage, including dental benefits that go beyond limited and emergency care. States should scorn waivers that reduce access to health coverage and jeopardize oral health through the imposition of so-called work requirements. Local leaders should instead heed recent data showing that Medicaid expansion has improved access to dental care for low-income adults and investments in dental care for adults support better oral health outcomes for future generations.

Oral health matters in the fight for racial and economic justice.

Investment in strong oral healthcare systems is cost effective, improves well-being, and saves lives. It should be a high priority for all of our lawmakers and every one of our communities.